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Partially-retained femoral sheath

Case contributed by Chris Newman
Diagnosis certain

Presentation

Elective catheter angiography with right femoral access. Part of femoral access sheath snapped off upon removal. ? location

Patient Data

Age: 70 years
Gender: Male
  • deep to the right-sided femoral puncture site there is a linear hyperdense foreign body in keeping with the suspected partially-retained sheath. It measures approximately 4 cm in length
  • preserved flow within the right femoral artery. No active bleeding or pseudoaneurysm
  • extensive calcified atherosclerotic disease seen throughout the imaged arteries
  • CT pelvis performed from approximately a year prior does not demonstrate the foreign body within the right common femoral artery
  • note the patient has extensive left perineal gas on this examination in keeping with Fornier gangrene

The photo shows a normal length 4 Fr sheath (left of image) beside the culprit snapped sheath in this case (right of image).

Case Discussion

Partially-retained femoral sheath following an elective catheter angiography. 

The reason the sheath snapped is not known, however the extensive hardened and calcified background atherosclerosis may have been the cause.

 

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