Purpose or Case Report: Pseudoaneurysms are uncommon vascular abnormalities contained by surrounding adventitial and perivascular tissues, often caused by a disruption of the arterial wall secondary to arterial injury or inflammation. Post-traumatic and iatrogenic pseudoaneurysms in children are especially rare, contributing to the insufficient literature regarding their care. Traditional treatment in adults for these lesions include surgical repair and angiography with embolization. Recently, minimally invasive endovascular techniques, such as percutaneous ultrasound-guided thrombin injection (UGTI), have become the first-line therapeutic choice for certain types of pseudoaneurysm. We present 3 patients with pseudoaneurysms treated with UGTI in uncommon locations.

Cases:
Case 1: 6-year-old female with trauma to the spleen from a bike accident who later developed a 1.6cm pseudoaneurysm of the spleen, which was treated with an injection of thrombin using ultrasound guidance.
Case 2: 9-year-old female with trauma to the lower leg after falling through a glass table who developed a 3.8cm pseudoaneurysm off the anterior tibial artery, which was treated with an injection of thrombin using ultrasound guidance.
Case 3: 13-year-old female with a 2.3cm iatrogenic pseudoaneurysm off the gluteal artery related to percutaneous transgluteal abscess drain placement, which was treated with an injection of thrombin using ultrasound guidance.
Methods & Materials:
Results:
Conclusions: Ultrasound-guided thrombin injection (UGTI) is a safe and effective means to treat traumatic and iatrogenic pseudoaneurysms in locations other than the common femoral artery. This technique may be safer than performing an angiogram with embolization for these patients and significantly reduces radiation exposure, often requiring no fluoroscopy for guidance.