Ruptured Pseudoaneurysm of Branch of Profunda Femoral Artery during Revision Total Hip Arthroplasty: a Case Report Case report for rupture pseudoaneurysm of branch of Profunda Femoral Artery during Revision Total Hip Arthroplasty
Main Article Content
Abstract
A ruptured pseudoaneurysm is a rare but potentially fatal complication during revision total hip arthroplasty. We report a case of a 46-year-old female with a rupture of a pseudoaneurysm at the branch of the left profunda femoral artery during revision total hip arthroplasty. The patient presented with dislocation of the left total hip arthroplasty, which failed closed reduction. During the revision surgery, a massive pulsatile bleeding occurred, which required an emergent vascular surgeon consultation to repair the ruptured pseudoaneurysm. It was later confirmed to be located at the branch of the left profunda femoral artery. Although rare, we recommend performing pre-operative CT angiography and consulting with a vascular surgeon before attempting revision total hip arthroplasty in patients with atypical symptoms, such as unusual thigh swelling and unexplained anemia.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Pivec R, Johnson AJ, Mears SC, Mont MA. Hip arthroplasty. Lancet 2012;380(9855):1768-77.
Patel I, Nham F, Zalikha AK, El-Othmani MM. Epidemiology of total hip arthroplasty: demographics, comorbidities and outcomes. Arthroplasty 2023;5(1):2.
Shichman I, Roof M, Askew N, Nherera L, Rozell JC, Seyler TM, et al. Projections and epidemiology of primary hip and knee arthroplasty in medicare patients to 2040-2060. JB JS Open Access 2023;8(1):e22.00112.
Abularrage CJ, Weiswasser JM, Dezee KJ, Slidell MB, Henderson WG, Sidawy AN. Predictors of lower extremity arterial injury after total knee or total hip arthroplasty. J Vasc Surg 2008;47(4):803-7.
Hamdulay KA, Beresford TP. Profunda femoris pseudoaneurysm rupture post dynamic hip screw fixation after physiotherapy. Ann R Coll Surg Engl 2021;103(3):e81-4.
Alshameeri Z, Bajekal R, Varty K, Khanduja V. Iatrogenic vascular injuries during arthroplasty of the hip. Bone Joint J 2015;97-B(11):1447-55.
Shoenfeld NA, Stuchin SA, Pearl R, Haveson S. The management of vascular injuries associated with total hip arthroplasty. J Vasc Surg 1990;11(4):549-55.
Baker S, Huddleston MK, Goodwin TM, Voskuil R, Sanders C. Left profunda femoral artery pseudoaneurysm after revision total hip arthroplasty. Arthroplast Today 2020;6(4):906-10.
Smith CD, Sridhar MS. Life-threatening, bleeding pseudoaneurysm of the external iliac artery in the setting of an infected total hip arthroplasty from Pasteurella multocida. Arthroplast Today 2020;6(3):560-5.
Harper K, Iorio J, Balasubramanian E. Profunda femoris pseudoaneurysm following total hip arthroplasty revision. Case Rep Orthop 2015; 2015:301949.
Nabhani S, Cheysson E, Sabbah P, Baaklini G. Endovascular management of a deep femoral artery perforating branch pseudoaneurysm after total hip arthroplasty: a case study. Case Rep Med 2022;2022:5925839.
Pollock JR, McQuivey KS, Braithwaite CL, Swanson J, Bingham JS. Pseudoaneurysm following two-stage hip revision with fasciotomy. Case Rep Orthop 2022;2022:6254542.
Nozawa M, Irimoto M, Maezawa K, Hirose T, Shitoto K, Kurosawa H. False aneurysm of the profunda femoris artery after total hip arthroplasty. J Arthroplasty 2000;15(5):671-4.
Huynh S, Kayssi A, Koo K, Rajan D, Safir O, Forbes TL. Avulsion injury to the profunda femoris artery after total hip arthroplasty. J Vasc Surg 2016;64(2):494-6.
Piolanti N, Giuntoli M, Nucci AM, Battistini P, Lisanti M, Andreani L. Profunda femoris artery pseudoaneurysm after intramedullary fixation for a pertrochanteric hip fracture. J Orthop Case Rep 2017;7(2):74-7.
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 2018;97(6):e9872.
Wilson JM, Escobar GA, Badrinathan B, Reimer NB. External iliac pseudoaneurysm secondary to medial wall penetration of an acetabular screw: a rare cause of total hip arthroplasty failure 15 years after implantation. Arthroplast Today 2019;5(3):264-8.
Diesel CV, Guimarães MR, Menegotto SM, Pereira AH, Pereira AA, Bertolucci LH, et al. Strategy to avoid vascular injuries in revision total hip arthroplasty with intrapelvic implants. Bone Jt Open 2022;3(11):859-66.