© 2011 Wichtig Editore - ISSN 1129-7298 J Vasc Access ( 2012; 1): 124-125 13 - 124 LETTER TO EDITOR ogous blood injection procedure and the patient’s com- plaints were diminished (Fig. 3). In control Doppler US performed one month after the procedure the IPA was fully regressed and the patient healed completely with- out any complication. There are different techniques and modalities for treatment of IPA. US-guided compression or percuta- neous thrombin injection are the first line treatment techniques in many centers (3). However, failure rates for the US-guided compression treatment is higher than the other kind of treatments (3, 4). In addition, percu- taneous thrombin injection has many disadvantages. It is relatively expensive and could lead to various com- plications (thrombotic complication, bleeding, anaphy- laxis, infection etc.) (3). Surgical treatment might also result in serious complications including death and should only be performed in cases where minimal in- vasive techniques fail (4). For these reasons, US-guided compression was our first choice in the case presented. In case of failure in US-guided compression we per- formed autologous blood injection therapy. As far we know, there is just one study in literature New and simple technique for iatrogenic femoral artery pseudoaneurysm treatment: Doppler US-guided percutaneous autologous blood injection Editor, Iatrogenic pseudoaneurysm (IPA) is a rare but well- recognized and important complication following angio- graphic studies (1). Pseudoaneurysm (PA) occurs from a defect in the arterial wall post-puncture with blood leak into surrounding inguinal tissue, forming a pulsatile he- matoma (2, 3). When IPA is not treated it could cause some important complications such as rupture and cata- strophic bleeding. We present a case of IPA following cardiac catheter- ization identified on Doppler ultrasound (US) and mul- tidetector computed tomographic angiography (MDCTA) prior to Doppler US-guided autologous blood injection therapy. To the best of our knowledge this new, simple, and easy treatment technique has not been reported in the literature. A 65-year-old woman was admitted to our interven- tional radiology unit with right inguinal pain, swelling, and color change following diagnostic cardiac angiog- raphy (three days ago). Gray scale US examination re- vealed a 34x27 mm pulsatile cystic lesion in the right groin. Doppler US examination revealed “to and fro blood flow” inside the lesion (Fig. 1). The case was there- fore diagnosed as IPA. However, the origin of IPA and the morphology of its neck could not be clearly dem- onstrated. In addition, US-guided compression treatment was applied upon IPA for 20 minutes. Following com- pression treatment, thrombosis in IPA was not detected. In 64-MDCTA (Aquilion, Toshiba Medical Systems) IPA was originated from the deep femoral artery (Fig. 2). US- guided compression treatment was performed (twice in the same day) on the patient a second time. Since three sessions of US-guided compression treat- ment failed, autologous blood injection treatment was planned. For this treatment 10 cc of blood was with- drawn using a 20 cc syringe. After waiting five minutes the blood in the syringe was given into IPA with 18 gauges at a point most distant to the neck. During au- tologous blood injection the blood flow throughout IPA was minimized by compression to the neck of IPA with US probe. At the same time, by using the same probe it was detected whether there was any thrombosis inside the IPA. Two minutes after completing autologous blood injection, full thrombosis of IPA was observed. There was no recanalization observed on control Doppler US performed one and two days after the autol- JVA-D-11-00037R1 DOI: 10.5301/JVA.5000011 Fig. 1 - Doppler US images of the patient before the US-guided percu- taneous autologous blood injection treatment. Iatrogenic pseudoaneu- rysm is seen.