Author + information
- Received May 31, 2017
- Revision received June 13, 2017
- Accepted June 20, 2017
- Published online August 30, 2017.
- Qassem Sanallah, MD,
- Ronen Rubinshtein, MD,
- Michael Gabrielly, MD and
- Ronen Jaffe, MD∗ ()
- ↵∗Address for correspondence:
Dr. Ronen Jaffe, Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, 7 Michal Street, Haifa, Israel 34362.
Femoral artery pseudoaneurysm due to infection of a vascular closure device is rare and potentially life threatening. Surgical repair of the blood vessel is the preferred therapy. We describe such a patient who was successfully treated percutaneously by implantation of a stent graft. A 60-year-old diabetic and morbidly obese woman underwent coronary stenting and deployment of a 6-F Angioseal vascular closure device (Terumo Interventional Systems, Somerset, New Jersey) in the right femoral artery. She subsequently developed an infected right groin hematoma with growth of Staphylococcus epidermidis and Streptococcus agalactiae in cultures of the hematoma fluid. Duplex ultrasound and computed tomography angiography demonstrated normal flow within the femoral artery without evidence of disruption of the vessel wall. The patient underwent surgical drainage of the hematoma and received ciprofloxacin for 3 weeks. Three months later, she presented with a giant pulsatile mass in the right groin. Computed tomography angiography demonstrated a large (11 cm) pseudoaneurysm of the right femoral artery, which was attributed to infection of the vessel wall (Figure 1, Online Videos 1 and 2). The patient was referred for surgical repair but was turned down due to comorbidities and likelihood of persistent infection at the surgical site. She was therefore treated percutaneously by implantation of a 10-mm × 60-mm vascular stent graft (Fluency, Bard Peripheral Vascular, Tempe, Arizona) via the contralateral femoral artery (Figure 2, Online Video 3). The patient received antibiotic therapy with amoxicillin and clavulanic acid for 6 weeks and has not required further vascular interventions during 6 months of follow-up.
For supplemental videos and their legends, please see the online version of this article.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received May 31, 2017.
- Revision received June 13, 2017.
- Accepted June 20, 2017.
- 2017 American College of Cardiology Foundation