Femoral Artery Puncture Site Pseudoaneurysm Formation Following Uterine Artery Embolization for Symptomatic Fibroids: A Case Report

Background: Uterine artery embolization (UAE) is a safe and durable alternative to hysterectomy for the treatment of fibroids. Complications arising in the femoral artery puncture site such as infection, bleeding, and hematoma formation have been reported. This is the first report of pseudoaneurysm formation following UAE. Case: A 46-year-old primiparous woman with multiple symptomatic fibroids became hypertensive during transfemoral UAE. The vascular sheath removal was delayed until blood pressure had normalized. Manual compression was required to control bleeding from the right groin puncture site. A subcutaneous hematoma developed, extending down to the patient's knee. Doppler ultrasound and CT arteriogram demonstrated a ruptured pseudoaneurysm. It was repaired by a vascular surgeon but became infected with E coli. The wound was healing well at three months after the procedure. Conclusion: Complications after UAE may be minimized by appropriate patient selection, proper surgical technique, and appropriate monitoring and follow-up.