Large Pseudoaneurysm Associated with Compressive Symptoms after Cardiac Catheterization

Abstract

This case study follows a patient who presented with a right burning thigh pain and diffuse swelling 6 months after cardiac catheterization. The patient had a medical history of coronary artery disease, hypertension, and at the time was also on warfarin therapy for atrial fibrillation. This persistent discomfort and pain was limiting her ambulation and prompted a trip to the emergency room; she was then sent to our lab for further evaluation for a pseudoaneurysm. In the course of evaluating this patient with duplex ultrasound and Doppler waveforms, a very large common femoral artery pseudoaneurysm (PSA) with a short <2-mm neck and obvious significant compression of the common femoral artery and common femoral vein was identified. Because of the short neck of the PSA, an open surgical repair was performed. Surgical notes observed significant compression of the common femoral nerve as well as the common femoral artery and vein. Postoperatively, there were no complications, and the patient has had some improvement in her neurological symptoms as well as completes resolution of the swelling of her right leg. Although postcardiac catheterization complications are minimal (0.5%), the use of ultrasound imaging is a simple and cost-effective means of addressing persistent patient discomfort and pain after cardiac catheterization.