A pseudoaneurysm, also known as a false aneurysm, is a locally contained hematoma outside an artery or the heart due to damage to the vessel wall.

The patient may describe a history of catheterization or trauma, and they may note that the pulsatile mass is gradually expanding.

Blunt or penetrating trauma can cause a disruption in the arterial wall, leading to a pseudoaneurysm.

A patient with such a history who presents with a painful, pulsatile, tender mass at the site of catheterization or trauma should be suspected to have a pseudoaneurysm.

The diagnosis should be confirmed using Duplex ultrasonography, which will reveal arterial blood flow into the pseudoaneurysm.

In contrast, the most common location for a true left ventricular aneurysm involves the apex of the heart.

The covered stent remains in place permanently, and the pseudoaneurysm, without a continuous flow of arterial blood, then thromboses.

The ultrasound probe can be pushed firmly against the patient's skin to compress the neck of the pseudoaneurysm for usually about 20 minutes.

Finally, it is also much less successful if the patient is taking aspirin, warfarin (Coumadin), or another anticoagulant, since these would prevent clotting of blood within the pseudoaneurysm.

[5] In addition to covered stent placement, another popular, minimally-invasive technique used today is ultrasound-guided thrombin injection.

One contraindication to this procedure is if there is an arteriovenous fistula (communication between an artery and vein), in addition to the pseudoaneurysm.

If this is present, thrombin injected into the pseudoaneurysm could then enter the venous circulation and possibly lead to distant thrombosis.