Endovascular Stent Grafting for Iatrogenic Deep Femoral Artery Injury After Short Femoral Nailing: A Case Report With a Three-Year Follow-Up

Injury to the deep femoral artery (DFA) is a rare but potentially life-threatening complication of intertrochanteric femoral fracture surgery. We describe a case in which this complication occurred during drilling for the distal screw insertion of a short femoral nail. A 4 cm pseudoaneurysm was treated with stent grafting. Hemostasis was promptly achieved, and no recurrence of the aneurysm was observed over three years. The stent remained intact without fracture or migration. Although the stent lumen became nearly occluded during follow-up, the patient remained asymptomatic without signs of lower limb ischemia. This case highlights the utility of stent grafting for managing large pseudoaneurysms in DFA injury, where coil embolization may be unsuitable. In cases of isolated DFA injury, treatment selection should be guided by the clinical indication for pseudoaneurysm management, rather than the objective of preserving long-term arterial patency.