Iatrogenic Femoral Artery Pseudoaneurysm (Treatment Options)

Iatrogenic Femoral Artery Pseudoaneurysm (FAP) forms when an arterial puncture site fails to seal(inability to apply hemostasis), allowing blood to jet into the surrounding tissues and form a pulsatile hematoma. These lesions lack a fibrous wall and are contained by a surrounding shell of hematoma and the overlying soft tissues. Pseudoaneurysms usually occurs in low puncture situations, because there is suitable mass of soft tissue to contain the bleeding, In contrast high puncture results in free hematoma due to lack of sufficient surrounding tissue. It can present as a new thrill or bruit, pulsatile hematoma, or marked pain or tenderness. Complications of Pseudoaneurysms include rupture, distal embolization, local pain, neuropathy and local skin ischemia.Unlike FAPs of a surgical or post-traumatic nature, catheterization-induced pseudoaneuriysm have usually a benign natural history (80% of cases resolve spontaneously).Several therapeutic strategies have been developed to treat this condition. They include ultrasound-guided compression repair (UGCR), compression repair by mechanical devices, surgical repair, and minimally invasive treatments (thrombin injection, coil embolization and insertion of a covered stents).