Q: What is the best prevention against development of femoral pseudoaneurysm after inadvertent femoral artery puncture or presumed hematoma formation after line removal? 


  Answer: To continue to compress site for 5 more minutes, after bleeding noticed to be stop. 

 Most femoral pseudoaneurysms formed within seventy two hours after removal of the arterial line or puncture. It has been shown that just spending extra five minutes to compress the site, even after bleeding seems to be stopped reduces the incidence of pseudoaneurysm formation.



References:

1. El-Jack SS, Ruygrok PN, Webster MW, et al. Effectiveness of manual pressure hemostasis following transfemoral coronary angiography in patients on therapeutic warfarin anticoagulation. 

2. Am J Cardiol 2006; 97:485. 1. Katzenschlager R, Ugurluoglu A, Ahmadi A, et al. Incidence of pseudoaneurysm after diagnostic and therapeutic angiography. Radiology 1995; 195:463.