Femoral Artery Pseudoaneurysm Caused by an Osteochondroma of the Femur: A Case Report

Introduction The osteochondroma is the most common benign tumor of bone. Typically asymptomatic bony protuberances are discovered in childhood or adolescence. Although vascular complications are rare, these bony spikes can course along an artery and cause severe arterial complications. Reported here is a case involving the use of color duplex ultrasonography (CDU) to identify a superficial femoral artery (SFA) pseudoaneurysm as a result of an osteochondroma. Case Report A 12-year-old girl had been experiencing left lower extremity pain for approximately 2 months. The pain became progressively severe, and her parents noticed that she was limping. Magnetic resonance imaging (MRI) demonstrated a mass in the left thigh, suggesting the possibility of a femoral aneurysm. A bony spicule was noted on x-ray at the distal femur, projecting posteriorly. Clinical evaluation revealed an impressive pulsatile mass in the left distal medial thigh. The left thigh was noticeably larger than the right with poor pedal pulses compared with the asymptomatic limb. CDU was performed and identified an aneurysm of the SFA at the adductor canal. There was unusual oscillatory flow in the SFA proximal to the aneurysm with monophasic signals distally. The large aneurysm size displaced the normal anatomic course of the SFA and vein. Ankle-brachial indices (ABI) were 0.72 and monophasic in the affected limb and >1.0 and triphasic in the contralateral limb. Angiography confirmed the CDU and MRA findings, demonstrating a large pseudoaneurysm at the adductor canal caused by an osteochondroma of the femur. At time of surgical repair, the bony spicule was noted to have eroded into the femoral artery. Conclusion Vascular complications as a result of an osteochondroma are rare. Rapid diagnosis is necessary to prevent serious arterial compromise in these young patients. CDU can quickly and accurately confirm the presence of a pseudoaneurysm when an osteochondroma is suspected.

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Perkutaninio šlaunies arterijos kateterizavimo vietinių komplikacijų gydymo taktika

Lietuvos chirurgija ◽

10.15388/lietchirur.2014.3.3895 ◽

2014 ◽

Vol 13 (3) ◽

pp. 177-183

Author(s):

Ingrida Ašakienė ◽

Andrius Černauskas ◽

Nerijus Misonis ◽

Vaidotas Zabulis ◽

Robertas Breivis ◽

...

Keyword(s):

Femoral Artery ◽

Vascular Complications ◽

Limb Ischemia ◽

Arterial Disease ◽

Treated Group ◽

Suspected Coronary Artery Disease ◽

Femoral Access ◽

Artery Pseudoaneurysm ◽

Access Complications ◽

Local Vascular Complications

Darbo tikslas Nustatyti po intervencinių kardiologinių procedūrų per šlaunies arteriją susidariusių vietinių komplikacijų dažnį, pažeidimo vietos tipą ir optimalų gydymo metodą. Tyrimo medžiaga ir metodai Atlikta 166 pacientų, 2007–2011 metais patyrusių vietinių komplikacijų po kateterizavimo dėl įtariamos vainikinių arterijų patologijos, ligos istorijų duomenų retrospektyvi analizė. Vietinės kraujagyslių komplikacijos diagnozuotos ir gydytos kraujagyslių chirurgų. Rezultatai Tiriamąją grupę sudarė 96 (57,8 %) moterys ir 70 (42,2 %) vyrų. Vidutinis pacientų amžius buvo 69,1 metų (±11,4 metai). 63 pacientams (38 %) nustatyta sutrikusi kojų arterinė kraujotaka. Po kateterizavimo, atlikto dėl širdies kraujagyslių sistemos patologijos, šlaunies arterijos pseudoaneurizma išsivystė 162 (97,6%), arterioveninė fistulė – 3 (1,8 %), didelė hematoma – 1 pacientui. 111 (66,9 %) pacientų gydyta konservatyviai. Chirurginio gydymo prireikė 55 (33,1 %) pacientams. Operuotos 37 moterys (67,3 %) ir 18 vyrų (32,7 %). Vidutinis operuotų pacientų amžius buvo 69,9 (±10) metai. Pseudoaneurizmos pašalinimas ir arterijos plastika venos lopu atlikta 33 (60 %) pacientams, pašalinti krešuliai ir užsiūti arterijos defektai 22 (40 %) pacientams. Išvados Vietinių kraujagyslių komplikacijų po intervencinių kardiologinių procedūrų per šlaunies arteriją įvyko 166 pacientams (0,706 %). Dažniausia komplikacija po šlaunies arterijos kateterizavimo – pseudoaneurizma. Pseudoaneurizmos sėkmingai gydytos konservatyviai 111 pacientų (66,9 %). Punkcijos vietos kraujagyslių komplikacijos buvo dažnesnės ligoniams, kuriems buvo periferinių arterijų aterosklerozinis pažeidimas (p<0,01). Reikšminiai žodžiai: jatrogeninis šlaunies arterijos pažeidimas, pseudoaneurizma Treatment of local complications that develop after catheterisation through the femoral artery punctureIngrida Ašakienė, Andrius Černauskas, Nerijus Misonis, Vaidotas Zabulis, Robertas Breivis, Sigitas Tvarionavičius, Ramūnas Kvietkauskas ObjectiveTo determine what is the rate, type, and the best treatment of local femoral access complications after interventional cardiology catheterisation procedures through percutaneous femoral artery puncture.Materials and methodsRetrospective analysis of 166 patient medical records was carried out. All the patients underwent coronarography for the suspected coronary artery disease. All of them from 2007 to 2011 developed local femoral access complications. All complications were diagnosed and treated by vascular surgeons.ResultsThe study group consisted of 96 (57.8%) women and 70 (42.2%) men. The average age of the patients was 69.1 years (±11.4 years). Limb ischemia was determined in 63 patients (38%). After catheterisation due to cardiovascular pathology, femoral artery pseudoaneurysm developed in 162 patients (97.6%), arteriovenous fistula in 3 patients (1.8%), and massive hematoma in 1 patient; 111 patients (66.9%) were treated conservatively and 55 (33.1%) surgically. The surgically treated group consisted of 37 women (67.3%) and 18 men (32.7%). The average age of surgically treated patients was 69.9 (±10) years. Pseudoaneurysm removal and venous patch plasty were performed in 33 patients (60%). The removal of blood clots and direct suture of arterial defects were performed in 22 patients (40%).Conclusions166 patients (0.706%) developed local vascular complications after cardiovascular interventions through the femoral artery. Pseudoaneurysm was the most common complication after femoral artery catheterisation. Conservative treatment was successful in 111 patients (66.9%). Local vascular complications of the puncture site were more common in patients with a peripheral arterial disease (p < 0.01).Key words: iatrogenic femoral artery damage, pseudoaneurysm

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Pulsatile Mass: Ruptured Common Femoral Artery Pseudoaneurysm with Active Extravasation

Cureus ◽

10.7759/cureus.5380 ◽

2019 ◽

Author(s):

John O Patrick ◽

Michael J Yoo ◽

Neil P Larson ◽

Rachel E Bridwell

Keyword(s):

Femoral Artery ◽

Common Femoral Artery ◽

Artery Pseudoaneurysm ◽

Pulsatile Mass ◽

Active Extravasation

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Delayed superficial femoral artery pseudoaneurysm following distal femoral shaft fracture: A case report

The Kaohsiung Journal of Medical Sciences ◽

10.1016/j.kjms.2010.09.004 ◽

2011 ◽

Vol 27 (6) ◽

pp. 242-246 ◽

Cited By ~ 7

Author(s):

Sheng-Pin Lo ◽

Chih-Chiang Hsieh ◽

Chyun-Yu Yang ◽

Chii-Jeng Lin ◽

Chih-Wei Chang ◽

...

Keyword(s):

Case Report ◽

Femoral Artery ◽

Superficial Femoral Artery ◽

Femoral Shaft Fracture ◽

Femoral Shaft ◽

Shaft Fracture ◽

Artery Pseudoaneurysm

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Popliteal artery pseudoaneurysm due to femur exostosis

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492317703837 ◽

2017 ◽

Vol 27 (1) ◽

pp. 39-41

Author(s):

Wahid Syed ◽

Mohd Akbar Bhat ◽

Hakeem Zubair Ashraf ◽

Farooq Ganie ◽

Feroze Ahmad

Keyword(s):

Popliteal Artery ◽

Vascular Complications ◽

Surgical Excision ◽

Left Thigh ◽

Lower Limbs ◽

Patch Repair ◽

Medial Aspect ◽

Artery Pseudoaneurysm ◽

Multiple Exostoses ◽

Popliteal Artery Pseudoaneurysm

Vascular complications of femur exostoses are rare, with popliteal pseudoaneurysm being the most common. After establishing the diagnosis, surgical treatment is mandatory. A 35-year-old woman presented with a painful pulsatile swelling in the lower medial aspect of the left thigh. Investigations revealed a pseudoaneurysm arising from the left popliteal artery adjacent to femur exostoses. Skeletal survey revealed multiple exostoses involving the upper and lower limbs. Surgical excision of the pseudoaneurysm was followed by ePTFE patch repair of the defect and excision of the exostoses. The patient was discharged after 5 days and followed up for 6 months with excellent results.

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Femoral Artery Thrombosis Following Percutaneous Treatment with Thrombin Injection of a Femoral Artery Pseudoaneurysm: A Case Report

CardioVascular and Interventional Radiology ◽

10.1007/s00270-007-9024-7 ◽

2007 ◽

Vol 30 (4) ◽

pp. 789-792 ◽

Cited By ~ 10

Author(s):

Rajesh Bhat ◽

Sam Chakraverty

Keyword(s):

Case Report ◽

Femoral Artery ◽

Percutaneous Treatment ◽

Thrombin Injection ◽

Artery Pseudoaneurysm ◽

Artery Thrombosis

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Treatment of Common Femoral Artery Pseudoaneurysm: A Novel Approach Utilizing a VASCADE Percutaneous Closure Device

Case Reports in Surgery ◽

10.1155/2019/1397981 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Mark Dalvin ◽

Brandon Dessecker ◽

Eugene Vitvitsky

Keyword(s):

Case Report ◽

Femoral Artery ◽

Common Femoral Artery ◽

Percutaneous Closure ◽

Closure Device ◽

Thrombin Injection ◽

Artery Pseudoaneurysm ◽

Image Guided ◽

Novel Technique ◽

Novel Approach

Iatrogenic common femoral artery pseudoaneurysm is a well-known complication to vascular access. Many options, both surgical and nonsurgical, have been implemented as means to treat pseudoaneurysms such as thrombin injection, image-guided compression, and percutaneous closure devices. This case report demonstrates a novel technique using a VASCADE closure device to successfully treat an iatrogenic common femoral pseudoaneurysm.

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