Pseudoaneurysm Of Superficial Femoral Artery Research Articles

Superficial femoral artery pseudoaneurysm at implantation site of drug eluting stent discovered due to bacteremia: A case report

BACKGROUND Drug-eluting stents (DES) are used to treat lower extremity arterial disease. During DES treatment, aneurysmal degeneration occasionally occurs, especially with fluoropolymer-based DES. However, the incidence of pseudoaneurysms after DES placement is rarely reported in the lower extremity region, although there have been several reports on pseudoaneurysm formation after DES pla-cement in the coronary artery region. CASE SUMMARY We report the case of a 64-year-old man who presented with fever and pain in his left hand after dialysis. Bacteremia was diagnosed by blood culture, and after admission, he developed pain on the medial side of the right thigh. A pseudoaneurysm was observed in the right superficial femoral artery (SFA) at the proximal end of a previously placed DES. The bacteremia was thought to have been caused by a pseudoaneurysm of the left superficial brachial artery, and the pseudoaneurysm of the left superficial brachial artery was removed after antibiotic treatment. The pseudoaneurysm of the right SFA rapidly expanded after admission, but the expansion rate was reduced after infection control. Seven months after the first admission, the pseudoaneurysm of the left SFA was re-moved and in situ revascularization performed using a rifampicin-soaked Dacron graft. CONCLUSION Although pseudoaneurysm after DES placement in the lower extremity region is rare, it must be considered in patients with bacteremia.

Accuracy and feasibility in building a personalized 3D printed femoral pseudoaneurysm model for endovascular training.

The use of three-dimensional(3D) printing is broadly across many medical specialties. It is an innovative, and rapidly growing technology to produce custom anatomical models and medical conditions models for medical teaching, surgical planning, and patient education. This study aimed to evaluate the accuracy and feasibility of 3D printing in creating a superficial femoral artery pseudoaneurysm model based on CT scans for endovascular training. A case of a left superficial femoral artery pseudoaneurysm was selected, and the 3D model was created using DICOM files imported into Materialise Mimics 22.0 and Materialise 3-Matic software, then printed using vat polymerization technology. Two 3D-printed models were created, and a series of comparisons were conducted between the 3D segmented images from CT scans and these two 3D-printed models. Ten comparisons involving internal diameters and angles of the specific anatomical location were measured. The study found that the absolute mean difference in diameter between the 3D segmented images and the 3D printed models was 0.179±0.145 mm and 0.216±0.143mm, respectively, with no significant difference between the two sets of models. Additionally, the absolute mean difference in angle was 0.99±0.65° and 1.00±0.91°, respectively, and the absolute mean difference in angle between the two sets of data was not significant. Bland-Altman analysis confirmed a high correlation in dimension measurements between the 3D-printed models and segmented images. Furthermore, the accuracy of a 3D-printed femoral pseudoaneurysm model was further tested through the simulation of a superficial femoral artery pseudoaneurysm coiling procedure using the Philips Azurion7 in the angiography room. 3D printing is a reliable technique for producing a high accuracy 3D anatomical model that closely resemble a patient's anatomy based on CT images. Additionally, 3D printing is a feasible and viable option for use in endovascular training and medical education. In general, 3D printing is an encouraging technology with diverse possibilities in medicine, including surgical planning, medical education, and medical device advancement.

Spontaneous superficial femoral artery pseudoaneurysm: a rare case report

Spontaneous femoral artery pseudoaneurysm (PSA) is a rare disease and there are few reported cases. We report a case of a 45 year-old male with painless, non-pulsatile swelling in the medial aspect of left lower thigh, which is gradually increasing in size for a period of 2 months. He had no history of trauma or surgery. CT Angiography confirmed a large pseudoaneurysm of the left distal superficial femoral artery (SFA). Then patient had sudden rupture of the pseudoaneurysm and it was treated surgically by ligation of SFA proximal and distal to pseudoaneurysm with excision of large surrounding hematoma.

Percutaneous balloon-assisted ultrasound-guided direct thrombin embolization of superficial femoral artery pseudoaneurysm: a case series and literature review

BackgroundSuperficial femoral artery (SFA) pseudoaneurysms, a rare but potentially life-threatening complication, that can arise after vascular interventions or trauma. This case series explores the efficacy and safety of a minimally invasive treatment modality, percutaneous ultrasound-guided thrombin injection (PUGTI) combined with balloon occlusion, in three patients with SFA pseudoaneurysms.Case presentationThree patients (age: 71–82 years; 3 female) with SFA pseudoaneurysms underwent PUGTI with balloon occlusion. The procedure involved direct thrombin injection under ultrasound guidance while occluding the parent artery using a balloon catheter. Follow-up was conducted at 1 week and 1 month post-procedure to assess technical success, complications, and recurrence.ConclusionPUGTI combined with balloon occlusion appears to be a safe and effective treatment for SFA pseudoaneurysms, particularly for larger pseudoaneurysms. The procedure is associated with a high technical success rate. Balloon occlusion may offer a safer alternative to direct thrombin injection without occlusion, as it potentially minimizes the risk of complications such as distal thromboembolism.

FAUX ANEVRISMES POSTTRAUMATIQUES DE L’ARTERE FEMORALE SUPERFICIELLE : A PROPOS DE TROIS CAS OPERES

Post-traumatic superficial femoral artery pseudoaneurysm are rare. The aim of their treatment is to exclude the pseudoaneurysm from the arterial circulation while maintaining distal vascularization of the limb. That can be done by open surgical repair or by endovascular procedure. We report three cases of post-traumatic pseudoaneurysm of the superficial femoral artery operated on in our centre. The authors want to present three surgical treatment modalities for post-traumatic pseudoaneurysm, of the superficial femoral artery, namely direct suture, bypass using an inverted saphenous vein graft and ligation of the superficial femoral artery.

Spontaneous Pseudoaneurysm of the Left Superficial Femoral Artery: An Unusual Case Report and Review of Literature

Pseudoaneurysms are rare to occur and the rarest to occur in those who have not undergone surgical/endovascular procedures like catheterization. Such pseudoaneurysms are known as spontaneous pseudoaneurysms which are very less reported and reviewed. This generally occurs due to underlying pathological causes, the most common being atherosclerotic disease. The most common clinical presentation is a femoral artery pseudoaneurysm. Other less common presentations include aortic and visceral pseudoaneurysms. We describe here the occurrence of a pseudoaneurysm in a patient who has no history of endovascular procedures in the past and has a pseudoaneurysm showing a secondary change along with superadded infection of Acinetobacter baumannii. The case was radiologically diagnosed by a computed tomography scan of the abdomen and thigh, after which a surgical excision of the pseudoaneurysm was performed and the specimen was sent for the histopathological examination, which revealed secondary changes.

Neglected fracture shaft femur presenting with pseudoaneurysm: a case report

A pseudoaneurysm is a collection of blood leaking from a damaged arterial wall. Development of the false aneurysm is due to either initial injury of the vessel or is a complication of internal fixation of the femoral fracture. Femoral artery pseudoaneurysms (FAPs) may close spontaneously if the tear is small enough to allow for clotting and sealing. On the other hand, rupture of the aneurysm can trigger thrombosis, distal embolization and compression of adjacent structures. We present a case of left superficial femoral arterial pseudoaneurysm in a 36-year-old male with fracture of left femoral shaft. A 36-year-old male with history of road traffic accident presented to our institute with pain and swelling in left thigh. Patient was investigated and diagnosed with fracture left femoral shaft with a pseudoaneurysm of the left superficial femoral artery (SFA). Stenting was done for SFA followed by open reduction and internal fixation of the femoral shaft fracture. Such cases require multidisciplinary approach and a proper planning with involvement of different medical specialities to achieve optimal results and to minimise any intraoperative and post operative complications.

Successful Outcome in Posttraumatic Superficial Femoral Artery Pseudoaneurysm following Distal Femur Fracture

A 60-year-old woman sustained right femur fracture and presented to us after taking native massage therapy for 6 weeks. Radiographs showed suspected posteromedial soft tissue shadow. Further imaging confirmed a rare pseudoaneurysm of the superficial femoral artery. After vascular surgery consultation, a single-stage procedure was planned. Through medial approach to distal femur, Pseudo aneurysm was haemodynamically isolated, opened and its contents evacuated. Neck of pseudo aneurysm is located and ligated. Distal femur plating (broad DCP) was done through the same exposure. Since traumatic pseudoaneurysms are rare entities, surgeons should have a high degree of suspicion for preoperative identification. It facilitates simultaneous vascular repair and fracture fixation. It avoids two-stage incisions, two incisions, intraoperative or postoperative catastrophe, and medicolegal complications. Hence, we advocate to look out for vascular injury in distal femur fractures at a delayed presentation.

Delayed presentation of superficial femoral artery (SFA) pseudo aneurysm three month following trauma

This case report describes a rare delayed presentation of posttraumatic pseudoaneurysm of superficial femoral artery (SFA). A 22-year-old man presented with a painful expanding mass over the anteromedial aspect of the distal thigh three months after a motor traffic crash. The lump was tender and pulsatile on examination. CT angiogram revealed a pseudoaneurysm of distal SFA. Open surgical repair was done and the recovery was uneventful. It is to emphasize that absence of physical signs of vascular injury on immediate assessment following trauma does not exclude vascular injury and it can manifest as pseudoaneurysms even after months.

Delayed presentation of superficial femoral artery (SFA) pseudo aneurysm three month following trauma

Delayed presentation of superficial femoral artery (SFA) pseudo aneurysm three month following trauma

Delayed Traumatic Superficial Femoral Artery Pseudoaneurysm and Arteriovenous Fistula Over the Left Lower Limb

A pseudoaneurysm is a pulsating, encapsulated hematoma in communication with a ruptured vessel (1); there is an accumulation of blood between the tunica media and tunica adventitia layers of the vessel. We report a case of a young male with complaints of swelling, skin discoloration, and a tingling sensation of the left lower limb. A peripheral angiography was performed, which revealed an arteriovenous fistula at the middle of the left superficial femoral artery. The patient underwent a left superficial femoral artery pseudoaneurysm excision and repair. In this case report, we discuss the presenting clinical features, methods of evaluation, and the management of the superficial femoral artery pseudoaneurysm accompanied with arteriovenous fistula.

An Unorthodox Vascular Surgical Approach to Save a Limb

A 33 year old male intravenous drug user was referred urgently with right groin haemorrhage and acute limb threatening ischaemia after superficial femoral artery (SFA) puncture. A ruptured SFA pseudoaneurysm was detected by colour duplex ultrasonography. Young age, synchronous presence of abscess (Pseudomonas aeruginosa isolates), extensive tissue damage, and lack of appropriate venous conduit favoured an end to end anastomosis (A and B, asterisk) of the profunda femoral artery (PFA) to the distal SFA stump. Meropenem was administered for 21 days and a vacuum assisted closure device helped with wound healing. Using this provocative technique, successful revascularisation and lower limb salvage were achieved.Image 1

Infected Pseudoaneurysm with Necrotising Fasciitis Following Femoral Artery Catheterisation

Femoral pseudoaneurysm is the most common complication of femoral artery catheterisation usually diagnosed by colour doppler ultrasound. Ultrasound-guided compression has replaced surgery to be the mainstay of therapy due to its high success rate and low complications. The present case is about a 63-year-old female, who presented with pain and swelling in the right groin. She had undergone coronary angioplasty two weeks back. She developed fever, chills, wound induration and necrosis at the puncture site. A laboratory study revealed leucocytosis, elevated Erythrocyte Sedimentation Rate (ESR), and C-Reactive Protein (CRP). Ultrasound doppler showed a 4×2.8×2.7 cm pseudoaneurysm of the right superficial femoral artery with a to-and-fro flow pattern. Computed Tomography (CT) angiogram showed a large narrow neck pseudoaneurysm arising from the anterior wall of the proximal superficial femoral artery just distal to its origin. The right superficial femoral angiogram showed a pseudoaneurysm draining into a large cavity. She underwent an ultrasound-guided thrombin injection of the pseudoaneurysm. A thrombus was formed in the superficial femoral artery after thrombin injection and thrombosuction was done. The necrotic tissue was excised and skin grafting was done after the wound healed.

Endovascular Double-Layer Bare Stent Placement in the Treatment of Posttraumatic Pseudoaneurysm.

Objective To investigate the efficacy and safety of endovascular double-layer bare stent placement for the treatment of traumatic false aneurysm (TFA). Methods This is a retrospective review of five patients with TFA undergone double-layer bare stent placement in our center between February 2011 and August 2020. There are 2 males and 3 females aged 29-65 years, with an average age of 43 years. One case suffered from common carotid artery pseudoaneurysm, and four cases suffered superficial femoral artery pseudoaneurysm. Results The endovascular interventional treatment was successful in all 5 patients, and the pseudoaneurysms disappeared after treatment. No TFA recurrence and no complications such as instent stenosis, stent migration, stent fracture, endoleak, and infection were observed during the 3-99-month follow-up period. Conclusion For the treatment of TFA, endovascular interventional therapy with double-layer bare stent was minimally invasive, safe, and effective with fewer complications. It could preserve all branches of parent artery and had the advantage of lower cost. It can be used in the treatment of TFA in selected cases. However, further clinical researches with larger cohorts are needed before its long-term efficacy can be completely clarified.

Superficial Femoral Artery Pseudoaneurysm Secondary to a Femoral Osteochondroma: A Case Report and Review of the Literature

Background: Osteochondromas or Osteocartilaginous Exostosis are cartilage-capped bony growths arising from external bone surfaces. They typically occur at the level of growth plates and account for 30% of benign bone tumors. Vascular complications from osteochondromas are rare with roughly 112 reported cases in the literature dating back as early as 1953. Vascular injuries are location dependent, with popliteal pseudoaneurysms being the most prevalent. The operative techniques to repair these injuries have varied over time and are related to the location, degree of vascular injury, presence of thrombosis or infection and involvement of nearby structures like named veins or nerves. We present a case of a superficial femoral artery (SFA) injury secondary to an osteochondroma and offer a review of the literature evaluating the trends on operative repairs and their association with the degree of vascular injury. Methods: A total of 112 publications were found and independently reviewed. Articles containing age, sex, presentation, size of the aneurysm and surgical technique for repair were included for evaluation. Mean follow up, use of anticoagulation, and whether there was associated trauma was also recorded if reported by the authors. Articles with insufficient reported variables were excluded. A total of 49 publications were selected for evaluation based on these criteria. The review of literature was performed through PubMed, MEDLINE, NCBI using the words "pseudoaneurysm", "superficial femoral artery", "popliteal artery", and "osteochondroma". Results: Young Males were the most prevalent group (79.4%) with a mean age of 21.4 years of age. The most common complaint at presentation was pain and a palpable mass (81%) with no history of trauma (51%). Popliteal aneurysms (85%) were the most common vascular injury while the average size of injury was 5 mm. Operative techniques included arterioplasty (30.6%), end to end anastomosis (20.4%), greater saphenous vein (GSV) patch (20.4%) GSV bypass (8.1%) GSV interposition graft (8.1%) and xenopericardial or polytetrafluoroethylene (PTFE) patch (2%). Smaller arterial injuries (<5 mm) were most commonly managed with arterioplasty or end-to-end anastomosis. Conclusion: Vascular injuries secondary to osteochondromas are rare. High suspicion and prompt diagnosis are necessary to prevent long-term sequelae from neurovascular compromise. Smaller arterial defects appear to be best suitable for primary reconstruction either by arterioplasty or aneurysmectomy with end-to-end anastomosis. Ultimately, the surgical reconstruction needs to be guided in a case-by-case basis.

LEA 15. Rare Superficial Femoral Artery Pseudoaneurysm Formation After Drug-Coated Balloon Treatment

LEA 15. Rare Superficial Femoral Artery Pseudoaneurysm Formation After Drug-Coated Balloon Treatment

PSEUDOANEURYSM OF THE SUPERFICIAL FEMORAL ARTERY;

… The case report is of a 30-year male patient who had a fracture shaft of femurand after open reduction and internal fixation developed swelling which was painful and waspresent on the medial aspect of the thigh. It was decided to do an angiogram as the swellingwas expansile and confirmed superficial femoral artery pseudo aneurysm and the reason wasthought to be over penetration of the bit of the drill while doing the surgery for shaft of femurfracture. Treatment decided by the multidisciplinary team was to remove the condylar buttressplate, resection of the aneurysm and repair of the aneurysm with inter-positional graft

Melioidosis: An unusual presentation as mycotic pseudoaneurysm of Left Superficial Femoral Artery

Melioidosis
 is a potentially fatal infectious disease usually seen in, but not restricted
 to the tropical areas of the world. Burkholderia
 pseudomallei, a soil saprophytic bacterium are the causative agent. It can
 produce latent infection and reactivate many years after initial exposure and
 can have varied clinical presentations. Here we put forward an unusual yet
 successfully treated case of melioidosis presenting as mycotic pseudoaneurysm
 of superficial femoral artery. A 62 year old male patient came with a one and a
 half month old history of swelling and pain in the left thigh. Culture of blood
 and pus samples from the patient yielded Burkholderia
 pseudomallei. Combinations of surgical and medical management lead to a
 good outcome in the patient. J Microbiol
 Infect Dis 2018; 8(4):162-164.

Clinical evaluation of covered stents in the treatment of superficial femoral artery pseudoaneurysm in drug abusers.

The present study aimed to investigate the technical feasibility and initial clinical outcomes of a covered stent for the endovascular treatment of superficial femoral artery (SFA) pseudoaneurysm in drug abusers. A total of 29 drug abuse patients with SFA pseudoaneurysm, as confirmed by color Doppler sonography, were enrolled to the present study between January 2012 and May 2014. All patients were treated percutaneously by implantation of a covered stent. Physical examination and lower extremity computed tomography angiography were performed at 1 and 9 months postoperation. Furthermore, the ankle-brachial index (ABI) of all patients was measured. The results indicated that placement of the covered stent was technically successful in all 29 patients. All of the ruptured pseudoaneurysms were successfully sealed with no cases of intraprocedural mortality. In addition, all patients' conditions improved rapidly; active hemorrhage subsidence and vascular bruit disappearance were immediately detected following implantation of the covered stent. During the follow-up period, pain was markedly alleviated and pulsatile mass was decreased as time increased. No complaints or complications were documented. A total of 9 months postoperation, pain and pulsatile mass were not detected. The patency rate of the stent was 100%, and no migration, occlusion or infection was detected. In addition, the ABI was significantly improved, from 0.52±0.09 to 0.97±0.37 (P<0.01). In conclusion, the placement of a covered stent may be considered a promising approach to provide an effective, safe and minimally invasive option for the treatment of SFA pseudoaneurysm in drug abusers.

Distal Femoral Arteriovenous Fistula with Iliac Vein Thrombosis after Blunt Trauma

A 39-year-old woman arrived at our emergency department, complaining of severe pain and swelling of her left leg. She had slipped down stairs and injured on her left leg about 3 months ago. Computed tomography angiography showed left distal superficial femoral artery’s pseudoaneurysm with arteriovenous fistula and thrombotic occlusion of left common iliac vein. We decided to do endovascular intervention due to severe venous hypertension and chronic inflammation around the fistula. The femoral arteriovenous fistula was closed via stent-graft (7 mm×5, 9 mm×5 cm) deployment. The occluded left iliac vein was reopened by nitinol metal stenting (12 mm×4 cm, 14 mm×4 cm). The authors report a very rare case of femoral arteriovenous fistula combined with iliac vein thrombosis developed after a blunt trauma.