Iatrogenic femoral artery pseudoaneurysm complicating vascular access for haemodialysis in a patient with end-stage renal disease; unexpected occurrence after a common procedure

Pseudoaneurysm is a collection of blood formed as a result of a vascular injury and retained in the tissues surrounding the vessel breached. There is a complete rupture through the three walls of the artery: The intima, media, and adventitia are compromised. In the femoral region, the escaping blood pools as a well-circumscribed mass and is constrained by the surrounding soft tissues. Pseudoaneurysms can develop following penetrating trauma or arterial catheterization. It can uncommonly complicate procedures in the femoral region. Ultrasound-guided compression repair, minimally invasive percutaneous treatments, and surgical repair are the three therapeutic options. We present a 58-year-old woman with end-stage renal disease who developed a pseudoaneurysm of the femoral artery caused by inadvertent puncture of the artery in an attempt to catheterize the femoral vein for an emergency hemodialysis. The pseudoaneurysm was treated by ultrasound-guided compression. It is important to recognize the indications for surgery to avoid delay in the management of this potentially limb- or life-threatening condition.