Balloon-assisted Percutaneous Thrombin Injection for Brachial Artery Pseudoaneurysm after AV Fistula Cannulation

Pseudoaneurysms of arteriovenous fistulas (AVF) are often requiring surgical intervention.Herein, a male patient undergoing hemodialysis developed a brachial artery pseudoaneurysm of a radiocephalic AVF and presented with edema and pain in the right arm.Fistulography and ultrasonography revealed a brachial artery pseudoaneurysm.To prevent the potential migration of the thrombus to the brachial artery, we administered an ultrasound-guided percutaneous thrombin injection (UGTI), assisted by a balloon inflation in the brachial artery lumen.At 1-year followup, the AVF access remained functional.The balloon-assisted percutaneous UGTI could be an effective nonsurgical treatment for AVF pseudoaneurysms and vascular access maintenance.