J Korean Soc Radiol.  2019 Jul;80(4):761-767. 10.3348/jksr.2019.80.4.761.

Transcatheter Arterial Embolization with N-Butyl Cyanoacrylate for Profunda Femoris Artery Pseudoaneurysms Caused by Femur Shaft Fractures: Two Case Reports

• Lee J
• Kim Y
• Park KS
• Lee J
• Lee SH

• KMID: 2457454
• DOI: http://doi.org/10.3348/jksr.2019.80.4.761

Abstract

Pseudoaneurysm formation in the profunda femoris artery (PFA) is a rare complication of femur shaft fractures or, more usually, a consequence of operative repair. Over the past few years, percutaneous transcatheter arterial embolization (TAE) has increasingly been considered the most effective treatment for pseudoaneurysms of the PFA. We report two cases with pseudoaneurysms of the PFA that were caused by femur shaft fractures and were successfully treated using TAE with n-butyl cyanoacrylate (NBCA). When a pseudoaneurysm of the PFA occurs due to a femur shaft fracture, early recognition and prompt radiologic intervention may prevent severe vascular injury without the need for additional surgery. The advent of TAE using NBCA enables minimally invasive treatment to be undertaken and it is effective for managing pseudoaneurysms of the PFA.

MeSH Terms

Aneurysm, False*
Arteries*
Cyanoacrylates*
Embolization, Therapeutic
Enbucrilate
Femoral Artery
Femoral Fractures
Femur*
Vascular System Injuries
Cyanoacrylates
Enbucrilate

Figure

• 

  Fig. 1 A 26-year-old male admitted for a left femur fracture (Case 1). A. An axial computed tomography scan obtained five days after admission shows a pseudoaneurysm (arrow) within the left adductor magnus muscle. B. Angiography via the left femoral artery demonstrates a pseudoaneurysm (arrowhead) arising from the bifurcation of the second deep perforating branch of the profunda femoris artery. C. An angiography after injection of a 1:3 mixture of n-butyl cyanoacrylate and iodized oil demonstrates the occluded feeding artery and the pseudoaneurysm.

• 

  Fig. 2 A 71-year-old man admitted for a right femur fracture (Case 2). A. Selective angiography demonstrates a feeding artery and the pseudoaneurysm (arrow) that arises from the third deep perforating branch of the profunda femoris artery. B. Embolization with a 1:2 mixture of n-butyl cyanoacrylate and iodized oil was performed, and a subsequent angiography shows the successful exclusion of the pseudoaneurysm.

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