Femoral artery pseudoaneurysm after endovascular procedure in stroke patients: Case series

Background

Femoral artery access site complications are uncommon but likely to become more frequent with the increased use of endovascular procedures in stroke patients.

Aims

This study aims to describe the clinical, diagnosis and treatment features of a consecutive case series of femoral artery pseudoaneurysms (FAP).

Methods

A retrospective case series was performed for consecutive patients diagnosed with FAP at our institution between January 2016 and January 2020. Variables regarding patient demographics, endovascular procedural features and PAF description, diagnosis, treatment and outcomes were included.

Results

We identified a total of 9 cases in a 5-year period; six happened after acute endovascular therapy for stroke, 2 after diagnostic arteriography and 1 after subarachnoid hemorrhage related ruptured aneurysm embolization. Most patients experienced local symptoms but in 3 cases the PAF was incidentally discovered during the stroke diagnostic study. Only 1 of the patients experienced severe anemia related to the PAF. Regarding treatment, local compression and patient rest was enough in 2 cases, thrombine percutaneous injection was used in 3 patients and open surgery in 3. Nurse reports included evaluation of the groin status (pain, lump, bruise) prior to the PAF diagnosis in six patients.

Conclusions

The clinical presentation of FAP after endovascular procedure is heterogeneous and its diagnosis and management may be challenging. Systematic assessment of the groin after EP in stroke patients could help in prompt diagnosis and treatment of this complication.