ENDOVASCULAR REPAIR OF ARTERIAL PSEUDOANEURYSMS WITH USE OF A PERFUSION BALLOON CATHETER

PURPOSE: Pseudoaneurysms represent contained disruption of the arteria l wall, Iatrogenic pseudoaneurysms frequently complicate complex endov ascular procedures, With use of an animal model, the authors attempted to determine the safety and efficacy of using a perfusion balloon cat heter (PBC) to thrombose surgically created pseudoaneurysms. MATERIALS AND METHODS: An in vitro system measured maximum flow volume through a 5-F PBC, Pseudoaneurysms were created in domestic swine with use of a jugular vein patch anastomosed to a femoral arteriotomy, The PBC was inflated across the pseudoaneurysm neck for 30-minute intervals until thrombosis was confirmed by ultrasound, Completion arteriography was performed to evaluate for vascular complications. RESULTS: Maximum flo w through the PBC was 62.6 mL/min measured at a constant pressure grad ient of 120 mm Hg, Five pseudoaneurysms were created in four animals, The PBC completely thrombosed all five lesions, The mean treatment dur ation was 129 minutes (+/- 39 minutes SD), No native arterial injury, in situ thrombus, or distal embolization occurred, Partial recanalizat ion of three of the five treated pseudoaneurysms was identified on fol low-up arteriography and gross sectioning (n = 2 and n = 1, respective ly). CONCLUSION: The PBC safely and effectively thrombosed surgically created pseudoaneurysms. Partial recanalization of treated pseudoaneur ysms was demonstrated, Clinical trials are warranted.