• Images in cardiology

During transfemoral catheterisation one must be careful not to make the arterial puncture far below the inguinal ligament distal to the origin of the branches of the femoral artery. We illustrate a case of inadvertent puncture of the profunda femoris artery during diagnostic cardiac catheterisation. After the sheath was taken out full haemostasis could not be achieved despite prolonged manual pressure. Doppler ultrasound of the groin revealed a complex structure within the right groin consistent with an overlying haematoma. It was difficult to visualise the underlying native vessels and to help surgical planning a computed tomographic (CT) angiogram was done. This coronal section of the CT angiogram clearly shows a complex bi-lobed pseudoaneurysm arising directly from the right profunda femoris artery, separate from the right superficial femoral artery. There is an organising haematoma superficial to the pseudoaneurysm. Surgical repair of the puncture hole was successfully undertaken.