The femoral neuralgia syndrome after arterial catheter trauma.
The increasing number of diagnostic angiograms and interventional vascular procedures has resulted in a heightened awareness of serious catheter-related vascular trauma. We reviewed 50 consecutive catheter injuries of the femoral artery that required surgical intervention and focused specifically on their long-term outcome. The most common traumatic lesion was femoral pseudoaneurysm (60%) followed by uncontrolled hemorrhage (23%) and arterial thrombosis (17%). The most frequent chronic complaint of these patients was the femoral neuralgia syndrome affecting 15 of 50 patients (30%). Typically, these patients complained of postcatheterization pain in the groin, which radiated down the anteromedial thigh (anterior femoral cutaneous nerves), and was associated with residual hyperesthesias. The neuralgia gradually improved in 6 weeks to 1 year in most patients. Chronic pain, however, necessitated multiple visits to a pain clinic or physical therapy unit in four patients (27%) and resulted in unemployment in three (20%). We conclude that current catheter-related arterial injuries are commonly associated with a chronic femoral cutaneous neuralgia syndrome that has not been emphasized previously.
Hallett
J W
JW
Section of Vascular Surgery, Mayo Clinic, Rochester, MN 55905.
Wolk
S W
SW
Cherry
K J
KJ
Gloviczki
P
P
Pairolero
P C
PC
D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000209:etiology; D000792:Angiography; D015906:Angioplasty, Balloon, Coronary; D002404:Catheterization / Q000009:adverse effects*; D002908:Chronic Disease; D017023:Coronary Angiography; D005260:Female; D005263:Femoral Artery / Q000293:injuries*; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology* / Q000601:surgery; D013577:Syndrome; D013927:Thrombosis / Q000209:etiology