What should I do if I have subcutaneous bruising at the thigh root puncture after surgery?

  Interventional embolization of cerebral aneurysms is a minimally invasive procedure. The external wound visible to the naked eye is only a skin incision less than half a centimeter in length located in the groin, and the internal wound is only a puncture site on the anterior wall of the femoral artery, and the puncture site can be compressed to stop bleeding after surgery. Generally, the operator needs to compress the femoral artery puncture site for at least 10 minutes after surgery until there is no active bleeding. Postoperatively, the patient’s lower extremity on the puncture side needs to be immobilized for 12 to 24 hours. However, if the patient’s lower extremity is poorly braked after the procedure and the anticoagulant and antiplatelet drugs required for the intervention are applied, subcutaneous bruising and hematoma may occur at the puncture site, which may manifest as large subcutaneous bruising, petechiae, and swelling in the groin area. If there is blood flow communication between the lumen of the hematoma and the lumen of the femoral artery, a pulsatile pseudoaneurysm is formed. A simple subcutaneous bruise or hematoma can be treated by prolonging the local pressure bandage to ensure that there is no more active bleeding, and the subcutaneous bruise or hematoma will absorb on its own later. When a femoral artery pseudoaneurysm is suspected, color Doppler ultrasound of the femoral artery is required to determine the location, depth, size, and shape of the pseudoaneurysm to provide a basis for further treatment. It is generally recommended that pseudoaneurysms less than 1.8 cm in diameter or less than 6 cm3 in volume should be conservatively observed, and the chance of spontaneous disappearance of the aneurysm within 3 months can reach 93%; larger pseudoaneurysms can first seek ultrasound-guided compression repair or ultrasound-guided thrombin injection, and secondly, overlapping stent intervention or surgical repair can also be considered.