A 77-year-old man complained of left leg weakness. Right internal carotid artery stenosis was diagnosed. Percutaneous catheterization of the right internal carotid artery was performed, and an arterial closure device (Angio-Seal^®) was used for the right femoral artery. An infected femoral pseudoaneurysm later developed at the puncture site.
Emergency surgery using great saphenous vein (GSV) graft interposition was performed. On the 21st postoperative day, the GSV graft ruptured due to infection. Repeat GSV graft interposition was performed immediately. On the fourth postoperative day, the old GSV graft ruptured again. A bypass graft procedure from the right iliac artery to the popliteal artery was performed through the right obturator foramen with a polytetrafluoroethylene graft.
The postoperative course was uneventful and the patient was discharged from the hospital two months after the first operation.