Repeat Intervention Following Open Surgical and Interventional Treatment of Pseudoaneurysms: A Single-center Retrospective Cohort

Abstract Pseudoaneurysms may develop after percutaneous procedures, trauma, infection, or surgery. Although open and interventional treatments are widely used, comparative real-world evidence regarding repeat intervention remains limited. This single-center retrospective cohort included consecutive patients treated for pseudoaneurysm between January 2015 and August 2025. Patients underwent open surgical repair or interventional management. The primary outcome was repeat intervention for persistence, recurrence, or incomplete exclusion of the pseudoaneurysm. The association between treatment strategy and repeat intervention was evaluated using contingency-table analysis and univariable logistic regression. Seventy-seven patients were included: 43 (55.8%) underwent open repair and 34 (44.2%) received interventional management. Age, sex, sac area, and neck length were similar between groups. Iatrogenic etiology was more frequent in the interventional group (100.0% vs. 37.2%; p < 0.001). Repeat intervention occurred in 11 patients and was more frequent after interventional management than after open repair (29.4% vs. 2.3%). Interventional management was associated with higher crude odds of repeat intervention (odds ratio, 17.50; 95% confidence interval: 2.11–145.20; p = 0.001). Reliable multivariable adjustment was precluded by the small number of events, etiological imbalance, and quasi-complete separation. Interventional management was associated with more repeat interventions than open repair. However, marked etiological differences and limited event numbers restrict causal interpretation. Careful patient selection and structured surveillance are warranted after interventional treatment.