What is the most common artery involved in a pseudoaneurysm?

Most Common Artery Affected by Pseudoaneurysm

When it comes to pseudoaneurysms, the femoral artery is by far the most frequently involved vessel. This isn’t surprising, given how often it’s used for vascular access during routine medical procedures like cardiac catheterizations, angiograms, or interventions. Each time a catheter is inserted into the femoral artery—typically through the groin—there’s a small risk of vessel wall injury, which can lead to the formation of a pseudoaneurysm.

Studies consistently point to the femoral artery as the primary site, with a significant number of cases being iatrogenic—meaning they’re caused by medical treatment itself. Research by Koza and Kaya found that a striking 83.3% of pseudoaneurysms in their study were linked to medical procedures, underscoring how common this complication can be following catheterization. Other studies, like that of Jaiswal et al., still report high rates, with iatrogenic causes accounting for nearly 47% of cases.

While pseudoaneurysms can occur in other arteries—such as the axillary, brachial, or even visceral vessels—the femoral artery remains the most vulnerable due to its accessibility and frequent use in clinical settings. Fortunately, with improved techniques and ultrasound-guided procedures, the risk has decreased over time. Still, clinicians remain vigilant, as early detection and management are key to preventing complications like rupture or distal embolization.

In most cases, femoral pseudoaneurysms are manageable with ultrasound monitoring, compression, or minimally invasive treatments like thrombin injection. Awareness among both patients and providers helps ensure timely care when symptoms such as a pulsatile groin mass or localized pain arise.