Femoral artery pseudoaneurysm

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Post coronary angiogram right groin swelling and pain

Patient Data

Age: 70-75 years
Gender: Female

There is a large pseudoaneurysm arising from the anteromedial aspect of the right femoral artery, measuring 20 x 16 mm (trans X AP). Arising from the anterior aspect of this, and extending superiorly, there is a small outpouching which fills in on the delayed scan, likely indicating active extravasation. The neck of the aneurysm arises at the level of the inferior epigastric artery. There is a moderate right groin hematoma extending within the extraperitoneal space into the right iliac fossa.

Case Discussion

Post arterial puncture complications in the groin, such as pseudoaneurysms and AV fistulae, are best assessed initially with ultrasound. However due to the lack of ultrasound staff after hours, a CTA was performed instead in this case.

The pseudoaneurysm was successfully treat with US guided thrombin injection.

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