Ruptured Pseudoaneurysm of the Profunda Femoris Artery Due to Pellet Injury: Endovascular Treatment by Coil Embolization

Excerpt

We describe the endovascular management of a ruptured profunda femoris artery (PFA) pseudoaneurysm resulting from multiple buckshot pellet injuries. A 71-year-old man was referred with the diagnosis of ruptured pseudoaneurysm of the PFA. He had previously been in good health but, 6 months prior to the referral, had been accidentally shot while boar hunting. He suffered multiple shotgun buckshot pellet injuries to the lower abdomen and right thigh and underwent laparotomy, bowel resection, and colostomy. His postoperative course was stormy and complicated by two subsequent laparotomies for peritonitis, multiple organ failure, and stroke. After 6 months in the ICU and the medical ward, he was noted to have a pulsatile swelling in the right upper thigh. Ultrasound examination revealed a pseudoaneurysm of the PFA (Fig. 1). The patient gradually became hemodynamically unstable and developed shock, along with a further increase in the swelling. On arrival, urgent CT confirmed the diagnosis, showing a large ruptured pseudoaneurysm of the PFA with contrast extravasation (Fig. 2). Due to multiple comorbidities, he was considered too debilitated to tolerate a general anesthetic, and as a result, we opted for a minimally invasive approach.

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