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A 74 year old woman was referred to our hospital for percutaneous mitral valvuloplasty. She recently underwent diagnostic left and right heart catheterisation in a referring hospital. Several hours after manual sheath removal she noticed a painful swelling of her right groin. At physical examination a pulsating mass was found in the right groin measuring 5 × 5 cm and a systolic murmur could be heard over the area. It was decided to first visualise and treat a suspected false aneurysm of the right femoral artery.
The right superficial femoral artery was selectively engaged using a 5 French Sidewinder catheter from the left common femoral artery. Digital subtraction angiograms were made and a false aneurysm originating from the right superficial femoral artery was diagnosed (panel A, jet entering aneurysm). Under fluoroscopic guidance the aneurysm was punctured with an 18 G needle and a short 0.035 guidewire was introduced (panel B). After predilation, a 9 French Vasoseal system was introduced into the aneurysm. Through the cannula collagen plugs were inserted in the aneurysm (panel C, thrombosis ongoing). After thrombosis was completed (panel D, false aneurysm closed) there was immediate haemostasis at the puncture site and the canula could be withdrawn without any back bleeding. No additional manual compression was necessary. The whole procedure took less than 10 minutes. The subsequent mitral valvuloplasty was uneventful. This minimally invasive closure technique can easily be performed in any catheterisation laboratory and allows ad hoc treatment of false aneurysms by cardiologists unfamiliar with ultrasound equipment.
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