Figure 

A 61-year-old female with a history of heart failure with an ejection fraction of 23%, atrial fibrillation, and previous ischemic coronary disease underwent elective coronary angiography with palpation femoral puncture, with manual compression at the end of the procedure. The patient developed an inguinal hematoma with a bruit. On triplex-ultrasound, a permeable, 26mm false aneurysm of the superficial femoral artery and a fistula in the posterior wall with the femoral vein were identified Figure (A) and confirmed by angiography Figure (B, left arrow). An endovascular exclusion of the lesions with a covered stent was performed Figure (B, right arrow). The patient was discharged on the 1st postoperative day.

The femoral artery is a widely used access point for coronary catheterization. Various complications, such as hematoma, pseudoaneurysm, and ^{arteriovenous fistula}, can arise from these procedures. If the arteriovenous fistula is large, it may lead to leg ischemia or high-output heart failure. Close post-procedural surveillance and early diagnosis are essential to avoid serious complications.