0.2% to 0.5%*

“A pseudoaneurysm is defined as a false lumen that occurs at an arterial puncture site and contains active flowing arterial blood. A pseudoaneurysm differs from a true aneurysm in that it occurs as a “pouch” attached to an artery, while a true aneurysm is a circumferential thinning or weakness of an arterial wall. Pseudoaneurysms do not have arterial wall linings but are pulsatile hematomas (a collection of blood in the extravascular space) caused by blood flow through a wall defect.”

I had a new patient (inherited at the 3pm shift change) who complained that she had had cramp-like pains in her upper thigh since her right heart catheterization several days ago (and several days before a tentatively scheduled bypass). She hadn’t said anything before because she experienced leg cramps often, but now the pain was getting worse. The big thing they play up in school is a deep vein thrombosis, so I talk to her about some bedrest while I compare pedal pulses, leg warmth, and leg sizes. To be honest, that’s as far as my assessment expertise goes with DVT. She was a big lady, and to palpate her femoral artery I would have to push really hard. I was afraid to do that. I walked out of her room and was relieved to find cardiology was rounding. The NP came by and did some palpating and ausculated the artery. He then ordered a doppler to rule out a pseudoaneurysm. It came back positive for a femoral artery pseudoaneurysm.

The cardiologist ordered manual compression for 30 minutes to be done by a cath lab RN to be followed by another doppler. The doppler results came back saying the pseudoaneurysm had thrombosed.

And then my shift was over.

* What are the odds?