Signs and symptoms include hematomas that appear as an induration at the vascular access site and which can result in hypo tension, tachycardia, or a decrease in hemoglobin and hematocrit levels. Retro peritoneal bleeding presents as moderate to severe back or flank pain, hypo tension, tachycardia, ecchymosis, abdominal distension, or a decrease in hemoglobin and hematocrit levels. Femoral pseudoaneurysm and arteriovenous fistula can present as a bruit at the access site, or they can be asymptomatic.