A 69-year-old man presented with an expanding tissue mass over the medial aspect of his left thigh 6 weeks after a fracture of the distal femur shaft. Imaging studies confirmed a rare traumatic pseudoaneurysm of the superficial femoral artery. For the massive hematoma and persistent exsanguinating hemorrhage, staged interventions were taken. First, the pseudoaneurysm was hemodynamically isolated with an endovascular stent-graft placement. Subsequent surgical exploration and aneurysmectomy were performed later for the evacuation of the formed hematoma and the relief of the resultant compressive symptoms. Because traumatic pseudoaneurysm can have an insidious onset and delayed presentation, surgeons should consider the possible complication even after initial fracture fixation.
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