Endovascular Management of a Large Femoral Pseudoaneurysm: A Case Report and Literary Review

Femoral artery pseudoaneurysms have an increased incidence over the past few years due to the rise in percutaneous catheterization and so have the potential treatment options. Ultrasound-guided thrombin injection has been strongly studied, and data have shown its efficacy, safety, and superiority to ultrasound-guided compression therapy as well as open surgical repair; however, a less well-studied approach that appears to be burgeoning is endovascular stent repair. Many small studies and case reports have shown this option to be not only effective but also safe and might be the treatment option of choice in patients who are deemed high risk for surgical intervention or with complicated anatomical considerations at the site of injury. In this case report, we describe a 71-year-old man with an expanding right groin hematoma which was discovered to be a right superficial femoral artery pseudoaneurysm with a venous fistula connection to the common femoral vein. Due to the patient's venous fistula component, high surgical risk from substantial comorbidities, and large pseudoaneurysm size with a wide pseudoaneurysm neck, thrombin injection, compression therapy, and open surgical repair were ruled out as potential treatments; therefore, endovascular stent repair was performed. The procedure was successful, as was the patient's postoperative period. This case report and literary review can support and further validate the usage of endovascular stent repair to treat femoral artery pseudoaneurysms.