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Giovanni Solimeno: An Advanced Thrombin Injection Technique for Complex Femoral Pseudoaneurysms

Giovanni Solimeno/ LinkedIn

Oct 26, 2026, 14:28

Giovanni Solimeno: An Advanced Thrombin Injection Technique for Complex Femoral Pseudoaneurysms

Giovanni Solimeno, Vascular and Endovascular Surgeon at Pineta Grande Hospital, shared a post on LinkedIn:

“Thrombin injection in a femoral pseudoaneurysm with a long, beaded neck: when one needle is not enough.

Multiloculated femoral pseudoaneurysm. Neck about two centimetres, straight, perpendicular to the skin, arising from the first perforating branch of the profunda. And not a simple tube: a string of small chambers, like marbles in a row.

Usual rule, as in my previous posts: inject into the sac, close to the neck. Here I went one step further: into the first bead of the neck, right under the sac. A beaded neck is part of the lesion. Thrombose the sac alone and the beads could also stay open.

How I got there, with a standard spinal anaesthesia kit:

Short introducer needle into the sac, aimed at the neck, to holds the direction.
Long, thin spinal needle through it, to rail the lesion and reach the neck.
Thrombin in small aliquots, at the level where the neck encounter the sac: in this case, very slowly, more toward the neck than in the sac.

Honest limit: a spinal needle is far less echogenic than a standard syringe needle. Seeing the tip was the hardest part of the procedure (video below).

How do you manage a vertical, beaded neck?

With Antonio Contaldo, Mattia Silvestre.

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Proceed to the video attached to the post.

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