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Case Reports
. 2024 Jan 10;16(1):e52009.
doi: 10.7759/cureus.52009. eCollection 2024 Jan.

Iatrogenic Pseudoaneurysm of the Lateral Femoral Circumflex Artery Following Antegrade Intramedullary Femur Nailing: A Case Report

Nur Ayuni Khirul Ashar  1 , Imma Isniza Ismail  2 , Rahul Lingam  3
Affiliations
Case Reports

Iatrogenic Pseudoaneurysm of the Lateral Femoral Circumflex Artery Following Antegrade Intramedullary Femur Nailing: A Case Report

Nur Ayuni Khirul Ashar et al. Cureus. .

Abstract

Few cases of femoral artery pseudoaneurysm or its branches have been reported following intramedullary nailing of femur fractures. The occurrence of a false aneurysm of the lateral femoral circumflex artery (LFCA) for such a fracture has never been reported so far. We report a case of a young male with a delayed presentation of right thigh swelling following an antegrade interlocking nail femur. Ultrasonography and CT angiography of the right thigh confirmed a pseudoaneurysm communicating with LFCA. After unsuccessful ultrasound-guided compression therapy, the patient underwent embolization of the right LFCA pseudoaneurysm by an interventional radiologist. Although intramedullary nailing is considered a safe procedure, a pseudoaneurysm should be suspected when the patient presents with a painful swelling after the surgery. Glue embolization of the artery should be considered as one of the treatment options, as it yields favorable outcomes with less morbidity.

Keywords: iatrogenic pseudoaneurysm; intramedullary femur nailing; lateral femoral circumflex artery; trauma; vascular injury.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Plain radiographs of the right femur in lateral and anteroposterior (AP) views (A and B) reveal a midshaft right femur fracture with anterolateral displacement of the distal part, as indicated by the white arrow.
Figure 2
Figure 2. Post-operative plain radiographs of the right femur in oblique and anteroposterior (AP) views (A and B) show the interlocking nail femur in situ with a satisfactory fracture reduction.
Figure 3
Figure 3. A: Ultrasonography of the right thigh confirmed the diagnosis of pseudoaneurysm of LFCA (white arrow). B: The color Doppler image illustrates a typical characteristic of the yin-yang sign within the pseudoaneurysm sac.
Figure 4
Figure 4. Pre- and post-angiography images (A and B) depict the guided embolization of a false aneurysm in a branch of the lateral femoral circumflex artery (LFCA) (white arrow).
See this image and copyright information in PMC

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