What is a non-surgical treatment option for a pseudoaneurysm?

• A. Doppler-guided compression with or without thrombin injection
• B. Surgical vascular repair
• C. Observation only
• D. Immediate bypass graft

Answer: (A)

Doppler-guided compression therapy, with or without thrombin injection, is a minimally invasive way to treat a pseudoaneurysm without open surgery. The idea is to use real-time ultrasound to compress the neck of the pseudoaneurysm or to directly inject thrombin into the sac. This promotes rapid clot formation inside the pseudoaneurysm while preserving the parent artery, eliminating the abnormal channel that communicates with the arterial lumen. It’s preferred when feasible because it avoids the risks, recovery time, and complexity of surgical repair, and it has a high success rate for suitable lesions.

Surgical options, like vascular repair or immediate bypass graft, are invasive and reserved for cases where non-surgical methods fail, are contraindicated, or there are complications (such as rupture, infection, or limb threat). Observation might be considered only in very select, small, asymptomatic pseudoaneurysms that are likely to thrombose on their own, but is not the general approach.