Abstract：Objective To explore the value of contrast-enhanced ultrasound (CEUS) in diagnosis, treatment and efficacy evaluation of iatrogenic pseudoaneurysms (IPSA). Methods A retrospective analysis was conducted on the data of 39 patients with IPSA diagnosed and treated at the Hainan Hospital of PLA General Hospital from January 2013 to March 2024. Before treatment, conventional ultrasound was used to measure the size of the aneurysm, the diameter of the fistula, and the blood flow velocity of the fistula. CEUS was performed when necessary. The treatment options were as follows: compression therapy as the first choice, followed by ultrasound-guided thrombin occlusion for those who failed in compression therapy, and surgical intervention or covered stent implantation for those who failed in the above treatments or had contraindications. Statistical analysis was conducted on the parameters such as aneurysm size, fistula diameter, and blood flow velocity in the successful treatment groups. Results There were 34 cases (34/39, 87.18% ) of simple pseudoaneurysm and 5 cases (5/39, 12.82%) of complex pseudoaneurysm (combined with arteriovenous fistula or multiple aneurysms, etc.). Statistically significant differences were found in aneurysm size between the compression group and the thrombin occlusion group (P=0.048) as well as between the compression group and the surgical group (P=0.013). Similarly, statistically significant differences were observed in fistula size between the compression group and the thrombin occlusion group (P=0.006) and between the compression group and the surgical group (P=0.043). However, no statistically significant difference was found in blood flow velocity among the compression, thrombin occlusion, or surgical group. Conclusions CEUS is an effective diagnostic method for complex IPSA, and thrombin occlusion is an effective remedy for IPSA patients after failure of compression therapy.
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