Successful balloon-assisted percutaneous thrombin injection for common femoral artery pseudoaneurysm after venoarterial extracorporeal membrane oxygenation decannulation.

Femoral artery pseudoaneurysm is a serious vascular complication after venoarterial extracorporeal membrane oxygenation (VA-ECMO) decannulation, and optimal management remains challenging. We report the case of a 74-year-old man with acute pulmonary embolism who developed a common femoral artery pseudoaneurysm after VA-ECMO removal. Ultrasound-guided compression was unsuccessful, and surgical repair was considered but deferred because of the patient's clinical condition and operating room unavailability. Balloon-assisted percutaneous thrombin injection achieved complete thrombosis without distal embolization or other complications. This technique may represent a feasible, minimally invasive alternative to surgical repair for femoral artery pseudoaneurysms following VA-ECMO decannulation, particularly in high-risk surgical patients.