Recurrence of Dialysis Shunt Pseudoaneurysm Following Percutaneous Thrombin Embolization

We report an unusual case of a 58-year-old woman on maintenance hemodialysis who presented with an iatrogenic radial artery pseudoaneurysm proximal to a Cimino-Brescia fistula. The pseudoaneurysm was not amenable to ultrasonographic compression due to the vascular anatomy. The pseudoaneurysm recurred despite initial successful response to two direct injections of thrombin on separate occasions. We highlight the role of ultrasound and thrombin injection in the treatment of pseudoaneurysm and emphasize the need for follow-up ultrasound examination to monitor recurrence.