Femoral percutaneous access can give rise to complications. Although such complications have been reduced with closure systems, catheter diameters have increased for special procedures such as percutaneous prostheses, Mitraclips, etc. The onset of a diffuse haematoma that extends and disappears over time is normal. However, there are complications that previously required surgery and long hospitalisation, due to the characteristics of the puncture, surrounded by a large haematoma. Over time, we have learned how to manage such complications percutaneously, a simple and effective method.

The most common complication is pseudo-aneurysm on the arterial puncture site. With each heartbeat, a micro-spray at that point dilates a sac-like structure in the surrounding tissue. This can grow and cause pain, occasionally intense, and swelling of the leg. A physical examination reveals a continuous murmur in the area of the pseudo-aneurysm. It can be studied by ultrasound or CT scan to precisely determine the bleeding point. There are different options for closing pseudo-aneurysms. If it is small, a compressive bandage and bed rest is sufficient, with periodical check-ups. If it grows or the cavity is initially large, it has to be obliterated, closing the bleeding site. This can be done by injecting thrombin in the cavity if it is small, or by the implantation of coils (reference and figure).