Pulsatile Mass: Ruptured Common Femoral Artery Pseudoaneurysm with Active Extravasation

Abstract

Delayed rupture of a pseudoaneurysm represents an extremely rare and life-threatening complication of endovascular, radiographic, and cardiac procedures. We discuss a case of a 69-year-old man with delayed rupture of a known left common femoral artery pseudoaneurysm, highlighting the importance of rapid recognition, to include the use of point of care ultrasound, if available. Computed tomographic angiography allows for better anatomic characterization and aids in operative planning, which is the mainstay of treatment. However, surgical repair in ruptured pseudoaneurysms remains a high-risk procedure.

Fatal Femoral Pseudoaneurysm Rupture after Endovascular Intervention: A Case Report and Literature Review

“…Previous literature on femoral pseudoaneurysm rupture is shown in Table 1. [6][7][8][9][10][11] Spontaneous rupture of a femoral pseudoaneurysm rarely occurs in young patients with autoimmune diseases. 6,7 Patients experiencing rupture related to percutaneous vascular catheterization, as shown in Table 1, typically were older in age and presented symptoms such as acute pain and swelling in the groin area, accompanied by hemodynamic instability.…”

“…6,7 Patients experiencing rupture related to percutaneous vascular catheterization, as shown in Table 1, typically were older in age and presented symptoms such as acute pain and swelling in the groin area, accompanied by hemodynamic instability. [8][9][10][11] Also, in previous reported cases of rupture, most femoral pseudoaneurysms exceeded 5 cm in its longest diameter before rupturing, and surgery was the chosen treatment, primarily due to hemodynamic instability. 6,[8][9][10][11] It is noteworthy that our patient did not experience any pain prior to the onset of shock.…”

“…[8][9][10][11] Also, in previous reported cases of rupture, most femoral pseudoaneurysms exceeded 5 cm in its longest diameter before rupturing, and surgery was the chosen treatment, primarily due to hemodynamic instability. 6,[8][9][10][11] It is noteworthy that our patient did not experience any pain prior to the onset of shock. We suspect that the rupture led to massive bleeding, as indicated by the sudden drop in blood pressure, which in turn resulted in a drowsy mental state, preventing the patient from reporting any pain.…”

Autologous Blood-Clot Embolisation of Iatrogenic Femoral Artery Pseudoaneurysm Caused by Arterial Sheath Placement; A Case Report

“…1,2 The most critical complication of FAP is rupture. 3 Also, it can result in expansion, limb ischemia, compression neuropathy, distal embolisation, cutaneous ischemia above an aneurysm, and infection. 1,2,4 The therapeutic approach depends on the diameter of FAP and its symptoms.…”