Presentation
Right femoral artery catheter placed during resuscitation.
Patient Data
CT obtained 1 day prior to line removal shows appropriate placement in the right common femoral artery with no evidence of complication.
This ultrasound, obtained 2 days after removal of the femoral line, was ordered due to swelling, firmness, and tenderness at the access site. It shows a large, heterogenous fluid collection in the right groin/thigh, connected to the common femoral artery by a narrow channel with arterial waveforms, consistent with pseudoaneurysm and rupture.
This CTA obtained the day after the ultrasound clearly shows arterial extravasation from the right common femoral artery, feeding a large hematoma in the right groin/thigh.
Case Discussion
Two days after the line removal, swelling and tenderness was noted at the access site, so an ultrasound was ordered, which showed findings consistent with a common femoral artery pseudoaneurysm that had likely ruptured and formed a large hematoma. This was confirmed with CTA the following day, which showed active extravasation from the common femoral artery. A review of this case found that proper technique was used during arterial cannulation and removal, so the pseudoaneurysm was likely caused by the patient's underlying coagulopathy.
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