FAA

Case:  52 year old male is admitted to ICU with Right groin pain, fever, and palpable femoral artery. Patient had coronary angiogram via femoral artery a few months ago. Emergent duplex ultrasound shows Femoral Artery Aneurysm (FAA) with size 4 cm and of saccular morphology. What is the concern?


Answer: intramural FAA infection 

 The above question is designed to highlight the long term issues associated with femoral artery cannulation, a common procedure in ICU and other emergent settings. Studies have shown that the risk of complications related to FAA starts to increase once they start going beyond 3 cm and over 4 cm. As FAAs are more benign in nature, patients with smaller FAA can be followed clinically and with imagings. Any sign of rapid expansion, the development of intraluminal thrombus, or change of morphology to saccular aneurysm should prompt surgical evaluation, as this may be an indication of infection.

#surgical-critical-care
#infectious-diseases
#procedures


References:

1. Lawrence PF, Harlander-Locke MP, Oderich GS, et al. The current management of isolated degenerative femoral artery aneurysms is too aggressive for their natural history. J Vasc Surg 2014; 59:343.


2. Dawson J, Fitridge R. Update on aneurysm disease: current insights and controversies: peripheral aneurysms: when to intervene - is rupture really a danger? Prog Cardiovasc Dis 2013; 56:26.