Delayed superficial femoral artery pseudoaneurysm following distal femoral shaft fracture: A case report

A 69-year-old man presented with an expanding tissue mass over the medial aspect of his left thigh 6 weeks after a fracture of the distal femur shaft. Imaging studies confirmed a rare traumatic pseudoaneurysm of the superficial femoral artery. For the massive hematoma and persistent exsanguinating hemorrhage, staged interventions were taken. First, the pseudoaneurysm was hemodynamically isolated with an endovascular stent-graft placement. Subsequent surgical exploration and aneurysmectomy were performed later for the evacuation of the formed hematoma and the relief of the resultant compressive symptoms. Because traumatic pseudoaneurysm can have an insidious onset and delayed presentation, surgeons should consider the possible complication even after initial fracture fixation.

摘要一位69歲男性於左股骨骨幹遠端骨折6周後，在左大腿內側面產生一漸進性腫脹。影像檢查證實此為一少見位於淺股動脈的創傷後假性動脈瘤。針對已形成的血腫與持續、擠壓式滲血，我們採取階段式的介入方式來處理。先以經皮放置血管支架成功地控制假性動脈瘤後；再對巨大血塊與壓迫症狀進行手術探查與清除。因創傷後的假性動脈瘤其初始症狀可能不明顯與常見的延遲表現，外科醫師在臨床診察或追蹤時，即使在骨折內固定手術後仍需留心此一可能的併發症。