Ruptured common femoral vein pseudoaneurysm from a common femoral arteriovenous fistula presenting as lower extremity steal after radiofrequency ablation of the great saphenous vein

Venous pseudoaneurysm of the great saphenous vein stump as late complication of flush saphenofemoral ligation and stripping

Guidelines now recommend endovenous thermal ablation over open treatment of saphenous incompetence, but flush saphenofemoral ligation and stripping remain relevant when appropriately applied and expertly executed. Complications are rare but could be severe, needing further surgical correction. We report a unique case of a late venous pseudoaneurysm of the great saphenous vein stump after flush saphenofemoral ligation and stripping, successfully treated with surgical sac excision. We highlight the importance of continuous follow-up for patients previously submitted to open venous surgery.