A rare case of large femoral hematoma after femoral artery cannulation

Femoral vessel cannulation is a commonly performed procedure in clinical practice. However, hematomas are a frequent complication of this procedure. Notably, hematoma formation is more likely to occur with femoral arterial cannulation compared to venous cannulation. If a hematoma does form, management can range from external compression to surgical intervention. In this report, we present a rare case of a large femoral hematoma without external skin cover, which is an unusual presentation of a common complication associated with femoral vessel cannulation. An elderly female presented with complaints of a raw area, pain, and blackening at the site of femoral artery cannulation for 10 days. She underwent coronary angioplasty and stenting 20 days prior. On examination, she exhibited a large hematoma over the right groin at the cannulation site without external skin covering. She underwent hematoma debridement with a gracilis muscle flap covering of the exposed femoral vessels. Early recognition and prompt evacuation of hematoma, assessment of femoral vessel breach and its management, as well as plastic reconstruction of exposed vessels, are vital for favorable outcomes.