Large pseudoaneurysm arising from the deep femoral artery after hip fracture fixation

Figures

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  Figure 1. Frontal radiographs demonstrating (A) the comminuted left intertrochanteric hip fracture with separate lesser and greater trochanteric fragments (left), and (B) the comminuted left intertrochanteric hip fracture treated with internal fixation with proximally and distally locked short cephalomedullary nails (right).

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  Figure 2. Duplex ultrasound overlying the left groin demonstrating bidirectional flow in the pseudoaneurysm (i.e. ‘yin-yang’ sign).

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  Figure 3. Contrast-enhanced arterial phase axial computed tomographic (CT) images overlying the left hip demonstrating (A) hyperdense material anterior to the left hip in keeping with hematoma (left), and (B) hyperdense material that corresponds to the pseudoaneurysm, which is supplied by a small DFA branch coursing anteriorly and abutting a sharp osseous fragment (right).

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  Figure 4. (A and B): Frontal digitally subtracted angiography via a diagnostic catheter positioned in the proximal left DFA demonstrating a large pseudoaneurysm originating from a small DFA branch. The long, narrow and lobulated pseudoaneurysm neck can be see coursing along the cranial aspect of the pseudoaneurysm.

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  Figure 5. Postcoil embolization digitally subtracted angiography via a diagnostic catheter positioned in the left DFA demonstrating adequate embolization of the injured small DFA branch with complete exclusion of the pseudoaneurysm.