You may be familiar with aneurysms, which are bulges in a weakened section of a blood vessel, usually, but not always, in an artery. They can occur in any part of your body, including your brain.

But you might not know what a pseudoaneurysm is. As you might guess from the name, a pseudoaneurysm is a false aneurysm.

It occurs when the wall of a blood vessel is damaged. This can cause blood to leak out of the blood vessel and to collect in the surrounding tissue.

If you have a pseudoaneurysm, it’s important to get a diagnosis and the appropriate treatment because some pseudoaneurysms, if left untreated, may rupture.

Let’s take a closer look at what causes pseudoaneurysms, where they develop, as well as their symptoms, risk factors, diagnosis, and treatment.

Pseudoaneurysms occur in weakened or damaged areas of arteries. They can occur spontaneously or as the result of injury to an artery.

It’s not uncommon for a pseudoaneurysm to develop after a person undergoes a cardiac catheterization procedure.

In fact, research suggests that a pseudoaneurysm is a common occurrence when the femoral artery (a large artery in your groin area) has been repeatedly punctured during a catheterization.

A pseudoaneurysm typically develops close to the insertion spot where the narrow, flexible catheterization tube is threaded up toward the heart.

If the catheter is inserted in your groin area, the pseudoaneurysm may develop there.

The catheter can also be inserted into your neck or arm. So pseudoaneurysms can occur in those areas, as well as in other arteries in the body.

If a pseudoaneurysm is very small, you might not even realize that you have one. But if you notice an area that’s very tender or swollen, seek medical attention.

Your healthcare provider might suspect a pseudoaneurysm if you develop the following symptoms:

  • swelling or tenderness in a particular area, especially if you’ve recently undergone a procedure
  • a painful mass or lump
  • a whooshing noise called a bruit that your healthcare provider can hear with a stethoscope, which may suggest a blockage of blood flow through the artery or a narrowing of the blood vessel

Pseudoaneurysms can occur spontaneously.

They can also occur as the result of the following:

  • Cardiac catheterization. Designed to diagnose or treat certain heart conditions, a pseudoaneurysm may develop if an artery is punctured during this procedure.
  • Trauma. Trauma or damage to the aorta from an accident or wound can cause blood to start leaking, causing a pseudoaneurysm to form in the surrounding tissues.
  • Surgical complication. Accidental damage to the arterial wall during a surgical procedure may cause trauma to the artery that can lead to blood leaking into the surrounding areas.
  • Infections. Infections can sometimes lead to pseudoaneurysms. For example, it’s rare, but research has shown that some types of infections can cause a pseudoaneurysm to develop.
  • Existing aneurysms: Ruptures of existing aneurysms have also been known to cause pseudoaneurysms to develop.

Certain factors can increase your risk of developing a pseudoaneurysm. Some of these risk factors include:

Ultrasonography is the most commonly used diagnostic tool for detecting a pseudoaneurysm.

If your healthcare provider suspects you may have a pseudoaneurysm, they’ll probably order an ultrasound or another type of noninvasive test.

They may also recommend an angiogram. This test uses X-rays to look at your blood vessels more closely.

It involves having a long, thin catheter inserted into your blood stream. The catheter releases dye into your arteries, which makes it easier for your healthcare provider to inspect them on an X-ray.

An angiogram is a more invasive procedure, which means it carries more risks.

The initial treatment may depend, in part, on the size of the pseudoaneurysm.

For a small pseudoaneurysm, your healthcare provider may suggest watchful waiting. That means they’ll keep a close eye on it, using an occasional ultrasound to get a better look.

Your healthcare provider might recommend that you avoid activities like lifting or carrying heavy things in the meantime.

Larger pseudoaneurysms may need more immediate treatment. In the past, surgery was often the only option. In some cases, surgical repair may still be the best treatment option.

However, there are now other less invasive treatment options, including ultrasound-guided compression and ultrasound-guided thrombin injections, which are explained in more detail below.

Ultrasound-guided compression

Ultrasound-guided compression is typically used only for smaller aneurysms that don’t go away on their own.

Your healthcare provider will use an ultrasound probe to provide compression to the site in 10-minute cycles.

One downside is that it can be very uncomfortable. You might need some pain-relieving medication during the process. You might also need multiple episodes.

Research suggests that success rates can vary with this procedure, ranging from 63 to 88 percent.

Ultrasound-guided thrombin injections

An ultrasound-guided thrombin injection is a minimally invasive procedure that’s a fairly simple process. However, it can be painful for some people.

Essentially, your healthcare provider delivers a solution containing thrombin, an enzyme that promotes clotting, into the pseudoaneurysm. The goal of this procedure is to cause the pooled blood to clot.

An ultrasound-guided thrombin injection is typically a safe procedure. According to a 2017 study, it provides positive results when treating femoral pseudoaneurysms. Another larger study also noted a low complication rate.

Surgery

Surgical removal was the primary treatment method until the 1990s. Once ultrasound-guided compression was introduced, surgery wasn’t the only option for treating a pseudoaneurysm.

Surgery usually involves removal of the pseudoaneurysm and repair to the weakened or damaged blood vessel wall.

Compared with newer techniques, surgery is more invasive and carries more risks. Plus, it typically requires a longer hospital stay.

However, it may be necessary for some people when other techniques aren’t successful or there are other complicating factors involved.

Noninvasive methods of treatment tend to have good success rates. After your treatment, your healthcare provider will likely monitor you for some time to make sure the procedure worked.

In some cases, you might need subsequent treatment. If you require more extensive treatment, however, you may need more careful or long-term follow-up care.

The size of your pseudoaneurysm may also play a role in your healthcare provider’s recommendations for your long-term prognosis.

A 10-year retrospective review of multiple research studies found some evidence that people with larger pseudoaneurysms may be more likely to develop another one.

According to the research, recurrence was more likely if the pseudoaneurysm was 2 cm in width or larger.

However, the researchers noted that some smaller studies didn’t find a link between pseudoaneurysm size and recurrence.

Research suggests that a condition called thrombocytopenia may also be a risk factor for recurrence.

People with this condition have a low platelet count. Platelets are special kinds of blood cells that help your blood to clot. When these platelets clump together, it stops your body from bleeding.

Pseudoaneurysms occur in weakened or damaged areas of arteries. The weakened artery can cause blood to leak out of the blood vessel and to collect in the surrounding tissue.

Pseudoaneurysms can develop in any artery, but they’re most common in the femoral artery, especially if you’ve undergone a cardiac catheterization procedure.

A pseudoaneurysm can also be caused by:

  • trauma
  • surgical procedures
  • infections

Treatment has evolved over the past few decades, giving you more noninvasive options.

It’s important not to ignore the symptoms of a pseudoaneurysm. If you think you have a pseudoaneurysm or may be at risk of developing one, be sure to talk to your healthcare provider about your concerns.