Outcomes of stent-graft repair for anastomotic femoral pseudoaneurysm. A case series

Objective: This study aims to report a case series of anastomotic femoral pseudoaneurysms (PSA) treated with stent-grafting (SG) in patients at high-risk for the open surgical approach. Methods: It is a retrospective, observational cohort study. Between 1 January 2002 and 1 April 2020, post-hoc analysis of the database including patients who received repair for femoral PSA identified those treated with SG. All but one patient were approached through a contralateral percutaneous transfemoral access, and the SG was always deployed from the common femoral artery to the profunda femoris artery. For this study, primary outcomes of interest were early (≤ 30 days) survival and patency rate. Results: We identified 10/823 cases of the entire PSA cohort (1.2%). There were 9 men and 1 woman: the mean age was 76 years ± 9 (range: 64–92). Urgent intervention was performed in 4 patients. The median operative time was 30 min (IQR: 25–36). Access-related complication was never observed. In-hospital mortality occurred in 1 patient due to novel coronavirus-19–related pneumonia. Median follow-up was 24 months (IQR: 12–37); 5 patients died. At the last radiologic follow-up available, all SGs were patent without necessity of reintervention. Conclusion: Stent-graft repair for anastomotic femoral PSA may be considered a reasonable alternative for patients at high-risk for open surgical repair.