Case Report: Subclavian Pseudoaneurysm Treated With Thrombin Injection.

Abstract

Central venous catheterization for hemodialysis carries the risk of vascular complications, including pseudoaneurysm formation. Traditional management includes manual compression, endovascular intervention, or surgery. A 19-year-old female with a kidney transplant history developed a large subclavian pseudoaneurysm (55 × 32 mm) following an internal jugular vein catheterization attempt for temporary hemodialysis. Manual compression failed to resolve the lesion. CT angiography confirmed a multilobulated pseudoaneurysm with active bleeding. Due to multiple comorbidities and the patient's refusal of surgery, balloon-assisted percutaneous thrombin injection was performed under ultrasound guidance. Complete pseudoaneurysm obliteration was achieved without complications. Follow-up ultrasound at 72 h showed complete thrombosis. Balloon-assisted percutaneous thrombin injection represents an effective, minimally invasive alternative to surgery for complex subclavian pseudoaneurysms, particularly suitable for high-risk patients with multiple comorbidities.