Cutaneous Signs of Vascular Disorders: Pseudoaneurysm

By Robert P. Blereau, MD

Sudden pain and a pulsatile swelling of the right upper medial thigh concerned an 80-year-old woman (A). Coronary angioplasty had been performed through this site 5 weeks earlier. An ultrasonogram revealed a 2-cm pseudoaneurysm of the right common femoral artery (B). A true aneurysm is a dilatation of the arterial wall. A pseudoaneurysm is a blowout of the arterial needle puncture site that results in perivascular blood collection. The blood is contained only by surrounding soft tissue, not by a blood vessel wall. A pseudoaneurysm may occur as a complication of any arterial puncture. A cardiovascular surgeon repaired the defect within hours of the onset of pain. Recovery was uneventful; there has been no recurrence.