Warfarin-associated intracerebral hemorrhage is a very serious complication of warfarin therapy with high mortality and morbidity. Initial ICH volume, presence of intraventricular hemorrhage, and ND are independent predictors of clinical outcome.

We report a case of obliteration of a large radial artery pseudoaneurysm complicating venous angioplasty in a patient with a left forearm Brescia-Cimino fistula. Obliteration was by combined balloon-assisted and ultrasound-guided direct percutaneous thrombin injections. The procedure was performed twice. There was subsequent salvage of the fistula with restoration of function and minimal cosmetic disfiguration following subsequent pseudoaneurysm shrinkage. This procedure provides a safe treatment of such complications and can be repeated. We describe the procedure and its advantages and discuss other treatment options.