Common femoral artery pseudoaneurysm

Case contributed by Dr Henry Knipe

Presentation

Two weeks post coronary angiogram. Ongoing groin pain.

Patient Data

Age: 65 years
Gender: Male
Ultrasound

Anterosuperior to the right common femoral artery. Ying-yang sign is demonstrated. 

More superiorly is a smaller hematoma without internal flow. Normal flow demonstrated within the common femoral artery pre and post pseudoaneurysm.

Case Discussion

Pseudoaneurysms (a.k.a. false aneurysms) are the most common complication after angiography, occuring in ~1% of diagnostic and ~4% of interventional procedures.

Risk of rupture increased with size > 3 cm, symptomatic pseudoaneurysms, increasing size or presence of associated large hematoma.

Although pseudoaneurysms may spontaneously thrombose, common treatment options include:

  • ultrasound-guided compression (success rate ~85%)
  • ultrasound-guided thrombin injection (success rate ~95%)
  • surgical repair

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