Journal of Ultrasound in Medicine, Vol 9, Issue 4 185-190, Copyright © 1990 by American Institute of Ultrasound in Medicine
Doppler sonographic demonstration of the progressive spontaneous thrombosis of pseudoaneurysms
P. S. Kotval, A. Khoury, P. M. Shah and S. C. Babu
Department of Radiology, New York Medical College, Valhalla.
In three patients with diagnosed pseudoaneurysms, surgical intervention was
delayed because of the patients' clinical condition. In successive
follow-up examinations in one patient, development of a new lobe to the
previously single-lobed pseudoaneurysm was noted with progressive
centripetal thrombus formation in each lobe leading to the eventual
complete thrombosis of the pseudoaneurysm without surgical intervention.
The sequence of steps leading to the complete thrombosis of the
pseudoaneurysm as seen by color Doppler and pulsed Doppler examination is
described. In two other patients with a single-lobed and a multilobed
pseudoaneurysm, respectively, follow-up examinations without surgical
management revealed complete thrombosis of the pseudoaneurysms. Whereas
traditional teaching holds that pseudoaneurysms require surgical repair,
this short series of cases suggests that, when progressive centripetal
thrombus formation is observed, the pseudoaneurysms can go on to complete
thrombosis. Follow-up for up to 4 months reveals no sonographic evidence of
rebleeding or other evidence of weakness in the arterial wall at the site
of the previous pseudoaneurysms.