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Femoral Artery Bypass Graft Pseudoaneurysm Rupture in a Transfemoral Amputee

Dallas, Jonathan, BS; Block, John J., MD; Bastas, Gerasimos, MD, PhD

American Journal of Physical Medicine & Rehabilitation: November 2018 - Volume 97 - Issue 11 - p e104–e106
doi: 10.1097/PHM.0000000000000908
Case Reports

The case of a patient with an actively bleeding pseudoaneurysm associated with remnants of a polytetrafluoroethylene femoral bypass graft in his transfemoral residual limb is described. Initial graft placement was due to peripheral arterial disease. During subsequent transfemoral amputation, remnants of the nonpatent graft were retained in the residuum. After 4 yrs of lower limb prosthesis use, a proximal anastomosis pseudoaneurysm developed (with avulsion of graft remnants). The patient presented to clinic with a 5-day history of increased left groin fullness and largely nonradiating pain (rated 10/10). He was diagnosed with a pseudoaneurysm (1.9 cm) originating from the left common femoral artery and an associated hematoma (8 cm) on computed tomography; this required emergent reoperation. This case highlights the importance surrounding the decision to leave or explant neovascularization materials, which may carry significant risk for infection or physical disruption complications in residual limbs.

From the Vanderbilt University School of Medicine (JD); and Departments of Radiology (JJB) and Physical Medicine & Rehabilitation (GB), Vanderbilt University Medical Center, Nashville, Tennessee.

All correspondence should be addressed to: Jonathan Dallas, BS, 1303 Wade Avenue, Nashville, TN 37212.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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