抄録
Iatrogenic pseudoaneurysm (IPA) is a common but important complication following femoral vein puncture. We report three cases of IPA following femoral vein puncture during radiofrequency catheter ablation (RFCA). These patients underwent insertion of two 8- to 8.5-Fr sheaths in the right femoral vein and a 3-Fr sheath in the right femoral artery. In the first case, the right inguinal region appeared swollen the morning after RFCA. IPA in the deep external pudendal artery (DEPA) was revealed on contrast-enhanced computed tomography (CECT). In the second case, the right inguinal region was swollen on day 7 after RFCA. IPA in the DEPA was revealed on CECT. In the third case, the right inguinal region appeared swollen the morning after RFCA. CECT showed IPA in the medial circumflex femoral artery (MCFA). These IPAs were treated by transcatheter arterial embolization with microcoils. Because thrombolytic-anticoagulant therapy for atrial fibrillation increases vascular complication rates and because the superficial external pudendal artery, DEPA and MCFA run inside the femoral artery, femoral vein puncture procedure easily injures these arteries. Preoperative anatomical evaluation of femoral branches on CECT or Doppler ultrasonography may be able to reduce the risk of IPA.
