A case of femoral pseudoaneurysm without inguinal mass or pain after femoral artery puncture

Pseudoaneurysms typically occur iatrogenically as a result of procedures such as femoral artery puncture, and are often associated with pain and a pulsatile mass, for which manual compression is the first treatment choice. Here we report a pseudoaneurysm without mass or pain that was found incidentally after femoral artery puncture. A 74-year-old woman with left middle cerebral artery occlusion underwent mechanical thrombectomy using a 9Fr sheath via the right femoral artery. After treatment, a hemostatic device was used to seal the sheath puncture site. No pulsatile mass or groin pain was noted thereafter. However, on the 17th postoperative day, a lower extremity ultrasound examination incidentally revealed a pseudoaneurysm of the right femoral artery. On the same day, ultrasound-guided compression was performed, and loss of blood flow to the pseudoaneurysm was confirmed. However, a repeat ultrasound examination on the following day demonstrated return of blood flow to the pseudoaneurysm. Ultrasound-guided compression was performed again, and repeat ultrasonography on the following day showed no resumption of blood flow to the pseudoaneurysm. The present case illustrates that pseudoaneurysms occurring after femoral artery puncture may not be associated with an inguinal mass or pain. Careful follow-up is also necessary because pseudoaneurysms may recur after manual treatment.