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
From the case:
Partially-retained femoral sheath
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/120696/annotated_viewer_json?_c=1669528279\u0026lang=us"}
- 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
From the case:
Partially-retained femoral sheath
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/120697/annotated_viewer_json?_c=1669528279\u0026lang=us"}
- 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
From the case:
Partially-retained femoral sheath
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/119897/annotated_viewer_json?_c=1669528279\u0026lang=us"}
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.