Accidental small bowel perforation after antegrade femoral artery access for percutaneous thromboembolectomy and angioplasty

Purpose: To report a rare complication of antegrade femoral access for percutaneous aspiration thromboembolectomy and transluminal angioplasty. Case Report: A 73-year-old obese woman underwent antegrade femoral aspiration thromboembolectomy for lower limb arterial embolism. Fifteen hours later, she presented with acute abdomen and decreased hemoglobin. Computed tomography showed small bowel obstruction, incarcerated femoral hernia, and free peritoneal air and fluid suggesting bowel perforation. Emergent laparotomy revealed an incarcerated, perforated femoral bowel loop and 4-quadrant peritonitis. Conclusions: Femoral hernia injury is an exceptional complication of vascular interventions. Knowledge of this potential hazard may help to avoid its occurrence.