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Ultrasound-guided thrombin injection of iatrogenic groin pseudoaneurysm: Doppler features and technical tips

¹ Department of Rodiology, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland, ² Abdominal Imaging, Princess Margaret Hospital, 610 University Avenue, Toronto, ON M5G 2MG, Canada, ³ Department of Medical Imaging, St Bartholomew's Hospital, West Smithfield, London ECIA 7BE, UK

Correspondence: Dr John M Hanson, Consultant Radiologist, Medical Imaging, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Louth, Ireland. E-mail: maryjohnny{at}eircom.net

The practice of angiographic procedures is increasing and, concomitantly, there has been an increase in the incidence of iatrogenic femoral pseudoaneurysms (PA). Ultrasound-guided thrombin injection is becoming the accepted gold standard in the treatment of PA. It is a cost-effective, safe and efficacious treatment that requires a short learning curve. The aim of this pictorial review is to demonstrate the Doppler and ultrasound features used to diagnose PA and those that help differentiate it from alternative diagnoses, and to describe the procedure of thrombin injection, highlighting technical tips and ways to avoid potential complications.