False Aneurysm of the Deep Femoral Artery as a Complication of Intertrochanteric Fracture of the Hip: Options of Open and Endovascular Repairs

Kizilates, Ufuk; Nagesser, S.K.; Krebbers, Yvonne M. J.; Sonneveld, D J A

doi:10.1177/1531003510365088

Cited by 15 publications

(6 citation statements)

References 9 publications

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“…Recent studies have reported that the MFCA originates from the DFA in 65% and the CFA in 31–32% of cases [ 23 , 24 ]. In contrast, pseudoaneurysm of the DFA after the surgery is also reported [ 25 , 26 ]. Although pseudoaneurysm was caused by the fracture itself in some cases, operative fault such as guidewire migration was considered to be the main reason.…”

Section: Discussionmentioning

confidence: 99%

Banding with lesser trochanter fragment using nonabsorbable tape in trochanteric femoral fractures

Usami

Takada

Nishida

et al. 2021

SICOT-J

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Introduction: Trochanteric femoral fracture is one of the most common fractures in the elderly. Trochanteric femoral fracture with involvement of the lesser trochanter is considered unstable and recognized as having a poor prognosis. However, fixation of lesser trochanter fragment is scarce because of technical difficulties. In this study, we reported the simple surgical procedure and the effect of using nonabsorbable tape in lesser trochanter fixation. Methods: From January 2014 to December 2017, 114 patients treated with proximal intramedullary nailing for trochanteric fractures with the lesser trochanter fragment were reviewed. Among patients enrolled in this study, 73 were followed up until radiographic bone union, of which 26 were treated with lesser trochanter fragment banding (group B) and 47 without banding (group N). Radiographs and/or computed tomography images were used to evaluate bone union of the lesser trochanter fragment at three months postoperatively. Results: The bone union of the lesser trochanter fragment was achieved in 24 cases (92%) in group B and 30 cases (64%) in group N. Compared with group N, group B showed a significantly increased number of mild and moderate deformities but decreased number of severe deformity and nonunion (P < 0.001). Postoperative complications were not observed in both groups. Conclusions: From the viewpoint of increasing lesser trochanteric bone union ratio, fixation of the lesser trochanter fragment using nonabsorbable tape in the treatment of trochanteric fractures could be an effective procedure.

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Section: Discussionmentioning

confidence: 99%

Banding with lesser trochanter fragment using nonabsorbable tape in trochanteric femoral fractures

Usami

Takada

Nishida

et al. 2021

SICOT-J

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“…However, other authors defend that in cases of large pseudoaneurysms open surgery would be the treatment of choice, reserving endovascular techniques for smaller cases [10]. In cases in which the aneurysm is produced by the displacement of the LT, the definitive treatment would be achieved with the extraction of the bone fragment after the arterial ligature [10], although in these cases, endovascular treatment has been shown to be effective and without risk of recurrence, as in our case [7]. Endovascular treatments include Coils, Stents, coagulant agents, or combinations of them, without evidence recommending one technique over another in this pathology.…”

Section: Discussionmentioning

confidence: 99%

“…The particularity of the treatment performed is that we did not remove the shifted LT fragment. Other authors also performed endovascular treatments in cases of pseudoaneurysm due to displacement of the LT with satisfactory results without evidence of recurrence [1, 7, 8, 10]. The late onset of a pseudoaneurysm of the deep femoral artery or its branches is a rare complication after hip fractures, but it should be suspected in a clinical setting of persistent pain after nailing, together with the late onset of edema and hematoma in the thigh and indirect signs in radiographs, such as medial and superior displacement of the lesser trochanter or the calcified femoral vessels.…”

Section: Discussionmentioning

confidence: 99%

Lateral circumflex femoral artery false aneurysm as a complication of intertrochanteric hip fracture with displaced lesser trochanter

Arbeloa-Gutierrez¹,

Arenas-Miquelez

Muñoa³

et al. 2019

Journal of Surgical Case Reports

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We present a patient who suffered an unstable intertrochanteric hip fracture and underwent osteosynthesis with a trochanteric nail. During the postoperative period, he presented a pseudoaneurysm of the lateral circumflex branch of the deep femoral artery secondary to a displaced fracture of the lesser trochanter. With the suspected diagnosis due to indirect clinical and radiological signs and confirmation by Doppler ultrasound and computed tomography angiography, a transverse arterial embolization with resolution of the symptoms was carried out. The pseudoaneurysm of the deep femoral artery or its branches is a very rare complication after intertrochanteric hip fractures, which must be taken into account in the late appearance of edema and hematoma in the thigh and evidence of medial and superior displacement of the lesser trochanter. The diagnosis is confirmed by CT angiography and the treatment by percutaneous arterial embolization has good results without the need of excising the lesser trochanter.

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“…The latter scenario involves either injury of the DFA by a displaced bone fragment or damage by a trochanteric gamma nail or an interlocking screw. 3,4…”

Section: Discussionmentioning

confidence: 99%

Cement fragment from hip arthroplasty causing deep femoral artery pseudoaneurysm

Gorospe

Tobío-Calo

Rodríguez-Díaz

et al. 2017

Asian Cardiovasc Thorac Ann

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An 81-year-old woman who had undergone total hip arthroplasty 12 years earlier presented with a painful spontaneous hematoma in the proximal left thigh. A left hip radiograph showed a displaced cement fragment from the acetabular component of the hip prosthesis. Computed tomography confirmed an extruded cement fragment causing a large pseudoaneurysm of the deep femoral artery. The patient underwent successful percutaneous embolization of the pseudoaneurysm with coils.

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False Aneurysm of the Deep Femoral Artery as a Complication of Intertrochanteric Fracture of the Hip: Options of Open and Endovascular Repairs

Cited by 15 publications

References 9 publications

Banding with lesser trochanter fragment using nonabsorbable tape in trochanteric femoral fractures

Banding with lesser trochanter fragment using nonabsorbable tape in trochanteric femoral fractures

Lateral circumflex femoral artery false aneurysm as a complication of intertrochanteric hip fracture with displaced lesser trochanter

Cement fragment from hip arthroplasty causing deep femoral artery pseudoaneurysm

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