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Delayed Bilateral Common Femoral Pseudoaneurysm after Percutaneous Access with Interventional Management: A Case Report

경피적 접근을 통한 시술 후에 발생한 지연성 양측 총대퇴 가성동맥류 및 인터벤션 치료: 증례 보고

  • Sang Hoon Lee (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Doo Ri Kim (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Jeong Sub Lee (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • In Chul Nam (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Su Yeon Ko (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine)
  • 이상훈 (제주대학교 의과대학 제주대학교병원 영상의학과) ;
  • 김두리 (제주대학교 의과대학 제주대학교병원 영상의학과) ;
  • 이정섭 (제주대학교 의과대학 제주대학교병원 영상의학과) ;
  • 남인출 (제주대학교 의과대학 제주대학교병원 영상의학과) ;
  • 고수연 (제주대학교 의과대학 제주대학교병원 영상의학과)
  • Received : 2022.06.26
  • Accepted : 2022.10.08
  • Published : 2023.05.01

Abstract

Common femoral artery pseudoaneurysm is a potentially serious complication of peripheral angiography. There have been few prior reports of simultaneous pseudoaneurysm in both common femoral arteries after percutaneous access. Here we report the case of a 58-year-old male patient who presented with phlegmon or abscess a few days after bilateral femoral access, after which newly developed bilateral femoral pseudoaneurysm with wide neck was observed on CT angiography 2 months after infection treatment. Because the patient refused surgery for pseudoaneurysm, a stent-graft was inserted in the left side, and percutaneous thrombin injection under US guidance with balloon occlusion was performed for the right side. Most pseudoaneurysms occur immediately after the causative procedure. However, there have been some cases in which pseudoaneurysms may occur several weeks or months later; it is therefore necessary to check the risk factors and to carefully observe the hemostasis site.

총대퇴동맥의 가성동맥류는 시술 후 천자 부위에 발생할 수 있는 심각한 합병증이다. 양측 총대퇴동맥에 동시에 발생한 가성동맥류는 매우 드물게 보고되었다. 저자들은 양측 총대퇴동맥 접근하에 하지혈관 시술을 한 58세 남자 환자에서, 시술 후 양측 서혜부 연조직염 및 농양이 생겨 치료하였는데 2개월 후 같은 위치에 가성동맥류가 발견된 증례를 경험하였다. 환자의 수술 거부로 좌측 가성동맥류는 스텐트 그라프트를 삽입하였고 우측 가성동맥류는 풍선확장술로 총대퇴동맥을 일시적으로 폐쇄한 후 초음파 유도하에 트롬빈을 주입하여 치료하였다. 가성동맥류는 대부분 시술 후 즉시 발생한다. 그러나 수주 혹은 수개월 후 지연성으로 발생하는 경우도 있기에 위험인자를 잘 확인하고 지혈 부위의 주의 깊은 관찰이 필요하다.

Keywords

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