Dr Graham Munneke, MRCP, FRCR is an Interventional Radiology Fellow at St George’s Hospital, London, where he has trained for the last 5 years. His interests include oncological and vascular intervention. Rob Morgan MRCP, FRCR, is a Consultant Radiologist and also specialises in interventional radiology. He is a member of the Council of the British Society of Interventional Radiology (BSIR) and the Cardiovascular and Interventional Radiology Society of Europe. Anna-Maria Belli, FRCR, is a Consultant Radiologist and Reader in Interventional Radiology at St George’s Hospital, specialising in vascular interventional radiology. She is the immediate Past President of the BSIR.

Graham John Munneke, Robert Morgan and Anna-Maria Belli
Department of Vascular Radiology, St George’s
Hospital, London, UK

Address for correspondence:
Dr Graham John Munneke, MRCP, FRCR
Department of Vascular Radiology
St George’s Hospital, Blackshaw Road
London SW17 OQT UK
Tel: +44 (0)208 725 3298
Fax: +44 (0)208 725 2936
Email: grahamm@doctors.org.uk

Abstract
Post-catheterisation pseudoaneurysms (PCPA) can develop when there is inadequate haemostasis at an arterial puncture site and occur at a rate of 7.7% following catheterisation. Risk factors for the development of PCPA and subsequent complications are described. Intravascular injection of thrombin has replaced ultrasound-guided compression as treatment for PCPA. Thrombin injection offers advantages including reduced procedure time, no requirement for sedation or local anaesthetic and a high technical success rate. A method is described for the slow injection of thrombin into the periphery of a pseudoaneurysm under continuous ultrasound scanning, which enables resolution with minimal risk of complications. A treatment algorithm for PCPA using thrombin injection is proposed.

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