Arch Plast Surg.  2014 Jan;41(1):81-84. 10.5999/aps.2014.41.1.81.

Pseudoaneurysm Leading to Necrotizing Fasciitis at the Femoral Arterial Puncture Site

• Hong SC
• Choi HJ
• Kim YB

• KMID: 2047894
• DOI: http://doi.org/10.5999/aps.2014.41.1.81

Abstract

In this article, we present two cases of femoral pseudoaneurysm (PA) at the femoral arterial puncture site followed by necrotizing fasciitis, which is rare but can be fatal when not managed appropriately. PA was revealed by lower-extremity angiography and color-flow Doppler ultrasonography. Hematoma removal, thrombolysis, and bleeder ligation with Gelfoam were repeatedly performed by a vascular surgeon. When necrotizing fasciitis developed, aggressive surgical drainage and creation of a viable wound bed for reconstruction were mandatory. We adopted a vacuum-assisted closure device (Kinetics Concepts International) as the standard treatment for complicated, serious, infected PA of the puncture site. Excellent clinical outcomes were obtained.

Keyword

Femoral artery; Fasciitis; Negative-pressure wound therapy; Aneurysm

MeSH Terms

Aneurysm
Aneurysm, False*
Angiography
Drainage
Fasciitis
Fasciitis, Necrotizing*
Femoral Artery
Gelatin Sponge, Absorbable
Hematoma
Ligation
Negative-Pressure Wound Therapy
Punctures*
Ultrasonography, Doppler
Wounds and Injuries