Pseudoaneurysm of the Lateral Femoral Artery: A Systematic Review of a Rare Complication in Patients With Pertrochanteric Fractures
Article Sidebar
Published:
Feb 14, 2022
Keywords:
Hip fractures, pseudoaneurysm, femoral artery, case report, systematic review
Main Article Content
Abstract
Introduction: We present a case of a lateral circumflex femoral artery pseudoaneurysm associated with pertrochanteric hip fracture.
Materials and Methods: We performed a systematic review considering all cases published in the last 15 years about this pathology (n=40).
Results: No statistically significant associations were found between any of the variables studied. However, there seems to be some consensus in maintaining a high clinical suspicion for early intervention, thus obtaining better outcomes. Both its etiology and location are related to the morphology of the fracture, the surgical procedure, and the osteosynthesis material. Likewise, there is a greater tendency to use CT angiography for the diagnosis and localization of the pseudoaneurysm.
Conclusion: Our patient is the first reported case of spontaneous resolution. Knowing this rare complication is essential to optimize therapeutic results. This review, the most recent on the subject, is very useful in listing and highlighting the most important aspects of the management and prevention of pseudoaneurysms secondary to hip fracture.
Materials and Methods: We performed a systematic review considering all cases published in the last 15 years about this pathology (n=40).
Results: No statistically significant associations were found between any of the variables studied. However, there seems to be some consensus in maintaining a high clinical suspicion for early intervention, thus obtaining better outcomes. Both its etiology and location are related to the morphology of the fracture, the surgical procedure, and the osteosynthesis material. Likewise, there is a greater tendency to use CT angiography for the diagnosis and localization of the pseudoaneurysm.
Conclusion: Our patient is the first reported case of spontaneous resolution. Knowing this rare complication is essential to optimize therapeutic results. This review, the most recent on the subject, is very useful in listing and highlighting the most important aspects of the management and prevention of pseudoaneurysms secondary to hip fracture.
Downloads
Download data is not yet available.
Metrics
Metrics Loading ...
Article Details
How to Cite
Royo Agustín, M., Castro Sauras, Ángel, Urgel Granados, A. C., García Fuentes, J., Ibarra Reyes, L., & Ranera García, M. (2022). Pseudoaneurysm of the Lateral Femoral Artery: A Systematic Review of a Rare Complication in Patients With Pertrochanteric Fractures. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 87(1), 95-110. https://doi.org/10.15417/issn.1852-7434.2022.87.1.1426
Issue
Section
Revisión Sistemática
Copyright (c) 2022 Revista de la Asociación Argentina de Ortopedia y Traumatología
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
References
1. Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 2006;17(12):1726-33. https://doi.org/10.1007/s00198-006-0172-4
2. Cao LH, Liu XW, Su JC, Zhang CC. Dynamic hip screw, Gamma nail and proximal femoral nail in treating
intertrochanteric fractures in the elderly: A prospective randomized biocompatibility study of 95 patients. J Clin
Rehabil Tissue Eng Res 2009;13(17):3342-46. https://doi.org/10.3969/j.issn.1673-8225.2009.17.031
3. Yang KH, Yoon CS, Park HW, Won JH, Park SJ. Position of the superficial femoral artery in closed hip nailing. Arch Orthop Trauma Surg 2004;124(3):169-72. https://doi.org/doi: 10.1007/s00402-003-0618-5
4. Zhang BF, Cong YX, Wang PF, Huang H, Wang H, Zhuang Y. Deep femoral artery branch pseudoaneurysm
formation and injury after hip fracture surgery: A case series and a literature review. Medicine (Baltimore)
2018;97(6):e9872. https://doi.org/10.1097/MD.0000000000009872
5. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for
reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009;33:b2700. https://doi.org/doi: 10.1136/bmj.b2700
6. Dameron TB Jr. False aneurysm of femoralprofundus artery resulting from internal-fixation device (screw). J Bone Joint Surg Am 1964;46:577-80. PMID: 14131436
7. Segal D, Yaacobi E, Marom N, Feldman V, Aliev E, Palmanovich E, et al. The incidence of life threatening
iatrogenic vessel injury following closed or open reduction and internal fixation of intertrochanteric femoral
factures. Int Orthop 2017;41(9):1845-50. https://doi.org/10.1007/s00264-017-3545-8
8. Barquet A, Gelink A, Giannoudis P V. Proximal femoral fractures and vascular injuries in adults: Incidence,
aetiology and outcomes. Injury 2015;46(12):2297-313. https://doi.org/10.1016/j.injury.2015.10.021
9. Rajaesparan K, Amin A, Arora S, Walton NP. Pseudoaneurysm of a branch of the profunda femoris artery following distal locking of an intramedullary hip nail: An unusual anatomical location. Hip Int 2008; 8(3):231-5.
https://doi.org/10.5301/hip.2008.3516
10. Raherinantenaina F, Rajaonanahary TMA, Ratsimba HNR. Update on diagnostic and therapeutic features of
peripheral artery pseudoaneurysms following orthopedic and traumatologic surgery. Rev Vasc Med 2015;3(3):16-21. https://doi.org/10.1016/j.rvm.2015.09.002
11. Vande Voorde K, Dauwe J, Van Oost J. Late presentation of an atrogenic pseudoaneurysm of the profunda femoris artery following intramedullary nailing. Case Rep Orthop 2018; 2018:8270256. https://doi.org/10.1155/2018/8270256
12. Lidder S, Epstein D, Courtice V, George M. Proximal femoral erosion: A sequelae of psuedoaneursym formation following operative fixation of an intertrochanteric neck of femur fracture. Indian J Orthop 2019;53(3):479-481. https://doi.org/10.4103/ortho.IJOrtho_139_18
13. Laohapoonrungsee A, Sirirungruangsarn Y, Arpornchayanon O. Pseudoaneurysm of profunda femoris artery
following internal fixation of intertrochanteric fracture: Two cases report. J Med Assoc Thail 2005;88(11):1703-6.
PMID: 16471122
14. Hanna GB, Holdsworth RJ, McCollum PT. Profunda femoris artery pseudoaneurysm following orthopaedic
procedures. Injury 1994;25(7):477-9. https://doi.org/10.1016/0020-1383(94)90279-8
15. Kim JW, Lee J Il, Park KC. Pseudoaneurysm of the deep femoral artery caused by a guide wire following femur
intertrochanteric fracture with a hip nail: A case report. Acta Orthop Traumatol Turc 2017;51(3):266-9.
https://doi.org/10.1016/j.aott.2017.03.011
16. Shrivastava V, Das N, Bratby M, Anthony S, Uberoi R. Endovascular management of vascular complications after elective orthopaedic surgery: A case series. CIRSE 2010. Cardiovasc Intervent Radiol 2010;33:277.
https://doi.org/10.1007/s00270-010-9954-3
17. Altuwaijri T. Ultrasound-guided thrombin injection versus ultrasound-guided compression repair in the treatment of post-catheterization femoral artery pseudoaneurysm: King Saud University Medical Center Experience. Turkish J Thorac Cardiovasc Surg 2020;28(1):114-9. https://doi.org/10.5606/tgkdc.dergisi.2020.18814
18. Malmstrom T, Simonsick E, Ferrucci L, Morley J. SARC-F: A symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle 2016;7(1) 28-36. https://doi.org/10.1002/jcsm.12048
19. Kang SS, Labropoulos N, Mansour MA, Baker WH. Percutaneous ultrasound guided thrombin injection: a new
method for treating postcatheterization femoral pseudoaneurysms. J Vasc Surg 1998 27(6):1032-8. https://doi.org/10.1016/s0741-5214(98)70006-0
20. Chandrasenan J, Garner JP, Meiring PD, Kumar K. Coil embolisation of an iatrogenic profunda femoris
pseudoaneurysm. Injury Extra 2006;37:249-52. https://doi.org/ doi:10.1016/j.injury.2005.12.025
21. Varastehravan H, Nough H, Ansari Z. Management of iatrogenic rupture of profunda femoris artery after femoral fracture fixation with stent graft implantation. J Tehran Univ Hear Cent 2010;5(1):42-4. PMID: 23074568
22. Sousa CMV, Silva LFP, Rodrigues ME, Félix A, Alpoim B, Marques P, et al. Spontaneous resolution of
pseudoaneurysm of an iliac artery branch in a multiple trauma patient with pelvic fracture. Clinical case. Rev Bras
Ortop (English Ed) 2011;1;46(1):87-90. https://doi.org/10.1016/S2255-4971(15)30182-8
23. Anderson OGP, Brookes JAS, Cobb J. False aneurysm caused by failed fracture fixation. Hosp Med 2005;66(7):422-3. https://doi.org/10.12968/hmed.2005.66.7.18389
24. Alwhouhayb M, Howard A, Çeliker V. A false aneurysm mistaken for a DVT after hip surgery. Ulus Travma ve Acil Cerrahi Derg 2005;11(2):178-9. PMID: 15877253
25. Ryzewicz M, Robinson M, McConnell J, Lindeque B. Vascular injury during fixation of an intertrochanteric hip
fracture in a patient with severe atherosclerosis: A case report. J Bone Joint Surg Am 2006;88(11):2483-6.
https://doi.org/10.2106/JBJS.F.00389
2. Cao LH, Liu XW, Su JC, Zhang CC. Dynamic hip screw, Gamma nail and proximal femoral nail in treating
intertrochanteric fractures in the elderly: A prospective randomized biocompatibility study of 95 patients. J Clin
Rehabil Tissue Eng Res 2009;13(17):3342-46. https://doi.org/10.3969/j.issn.1673-8225.2009.17.031
3. Yang KH, Yoon CS, Park HW, Won JH, Park SJ. Position of the superficial femoral artery in closed hip nailing. Arch Orthop Trauma Surg 2004;124(3):169-72. https://doi.org/doi: 10.1007/s00402-003-0618-5
4. Zhang BF, Cong YX, Wang PF, Huang H, Wang H, Zhuang Y. Deep femoral artery branch pseudoaneurysm
formation and injury after hip fracture surgery: A case series and a literature review. Medicine (Baltimore)
2018;97(6):e9872. https://doi.org/10.1097/MD.0000000000009872
5. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for
reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009;33:b2700. https://doi.org/doi: 10.1136/bmj.b2700
6. Dameron TB Jr. False aneurysm of femoralprofundus artery resulting from internal-fixation device (screw). J Bone Joint Surg Am 1964;46:577-80. PMID: 14131436
7. Segal D, Yaacobi E, Marom N, Feldman V, Aliev E, Palmanovich E, et al. The incidence of life threatening
iatrogenic vessel injury following closed or open reduction and internal fixation of intertrochanteric femoral
factures. Int Orthop 2017;41(9):1845-50. https://doi.org/10.1007/s00264-017-3545-8
8. Barquet A, Gelink A, Giannoudis P V. Proximal femoral fractures and vascular injuries in adults: Incidence,
aetiology and outcomes. Injury 2015;46(12):2297-313. https://doi.org/10.1016/j.injury.2015.10.021
9. Rajaesparan K, Amin A, Arora S, Walton NP. Pseudoaneurysm of a branch of the profunda femoris artery following distal locking of an intramedullary hip nail: An unusual anatomical location. Hip Int 2008; 8(3):231-5.
https://doi.org/10.5301/hip.2008.3516
10. Raherinantenaina F, Rajaonanahary TMA, Ratsimba HNR. Update on diagnostic and therapeutic features of
peripheral artery pseudoaneurysms following orthopedic and traumatologic surgery. Rev Vasc Med 2015;3(3):16-21. https://doi.org/10.1016/j.rvm.2015.09.002
11. Vande Voorde K, Dauwe J, Van Oost J. Late presentation of an atrogenic pseudoaneurysm of the profunda femoris artery following intramedullary nailing. Case Rep Orthop 2018; 2018:8270256. https://doi.org/10.1155/2018/8270256
12. Lidder S, Epstein D, Courtice V, George M. Proximal femoral erosion: A sequelae of psuedoaneursym formation following operative fixation of an intertrochanteric neck of femur fracture. Indian J Orthop 2019;53(3):479-481. https://doi.org/10.4103/ortho.IJOrtho_139_18
13. Laohapoonrungsee A, Sirirungruangsarn Y, Arpornchayanon O. Pseudoaneurysm of profunda femoris artery
following internal fixation of intertrochanteric fracture: Two cases report. J Med Assoc Thail 2005;88(11):1703-6.
PMID: 16471122
14. Hanna GB, Holdsworth RJ, McCollum PT. Profunda femoris artery pseudoaneurysm following orthopaedic
procedures. Injury 1994;25(7):477-9. https://doi.org/10.1016/0020-1383(94)90279-8
15. Kim JW, Lee J Il, Park KC. Pseudoaneurysm of the deep femoral artery caused by a guide wire following femur
intertrochanteric fracture with a hip nail: A case report. Acta Orthop Traumatol Turc 2017;51(3):266-9.
https://doi.org/10.1016/j.aott.2017.03.011
16. Shrivastava V, Das N, Bratby M, Anthony S, Uberoi R. Endovascular management of vascular complications after elective orthopaedic surgery: A case series. CIRSE 2010. Cardiovasc Intervent Radiol 2010;33:277.
https://doi.org/10.1007/s00270-010-9954-3
17. Altuwaijri T. Ultrasound-guided thrombin injection versus ultrasound-guided compression repair in the treatment of post-catheterization femoral artery pseudoaneurysm: King Saud University Medical Center Experience. Turkish J Thorac Cardiovasc Surg 2020;28(1):114-9. https://doi.org/10.5606/tgkdc.dergisi.2020.18814
18. Malmstrom T, Simonsick E, Ferrucci L, Morley J. SARC-F: A symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle 2016;7(1) 28-36. https://doi.org/10.1002/jcsm.12048
19. Kang SS, Labropoulos N, Mansour MA, Baker WH. Percutaneous ultrasound guided thrombin injection: a new
method for treating postcatheterization femoral pseudoaneurysms. J Vasc Surg 1998 27(6):1032-8. https://doi.org/10.1016/s0741-5214(98)70006-0
20. Chandrasenan J, Garner JP, Meiring PD, Kumar K. Coil embolisation of an iatrogenic profunda femoris
pseudoaneurysm. Injury Extra 2006;37:249-52. https://doi.org/ doi:10.1016/j.injury.2005.12.025
21. Varastehravan H, Nough H, Ansari Z. Management of iatrogenic rupture of profunda femoris artery after femoral fracture fixation with stent graft implantation. J Tehran Univ Hear Cent 2010;5(1):42-4. PMID: 23074568
22. Sousa CMV, Silva LFP, Rodrigues ME, Félix A, Alpoim B, Marques P, et al. Spontaneous resolution of
pseudoaneurysm of an iliac artery branch in a multiple trauma patient with pelvic fracture. Clinical case. Rev Bras
Ortop (English Ed) 2011;1;46(1):87-90. https://doi.org/10.1016/S2255-4971(15)30182-8
23. Anderson OGP, Brookes JAS, Cobb J. False aneurysm caused by failed fracture fixation. Hosp Med 2005;66(7):422-3. https://doi.org/10.12968/hmed.2005.66.7.18389
24. Alwhouhayb M, Howard A, Çeliker V. A false aneurysm mistaken for a DVT after hip surgery. Ulus Travma ve Acil Cerrahi Derg 2005;11(2):178-9. PMID: 15877253
25. Ryzewicz M, Robinson M, McConnell J, Lindeque B. Vascular injury during fixation of an intertrochanteric hip
fracture in a patient with severe atherosclerosis: A case report. J Bone Joint Surg Am 2006;88(11):2483-6.
https://doi.org/10.2106/JBJS.F.00389