Anévrisme athéromateux isolé de l’artère fémorale profonde

Journal of Vascular Surgery, 2008

Because there is a paucity of data about management and outcome of true profunda femoris artery aneurysms (PFAAs), we reviewed our 21-year experience with surgical repair of PFAAs. Methods: Clinical data from the 15 patients who underwent repair between 1985 and 2006 were retrospectively reviewed. Results: Fifteen men had 17 PFAAs (mean diameter, of 3.4 cm). Three had an acute presentation with rupture (n ‫؍‬ 2) or acute limb ischemia (n ‫؍‬ 1), one had local tenderness, and 11 were asymptomatic. Sizes of the ruptured PFAAs were 1.5 and 7.5 cm. Eleven patients (73%) had synchronous aneurysms, most frequently in the popliteal artery (n ‫؍‬ 7). Three of the asymptomatic patients required an emergency operation because of acute lower extremity ischemia caused by thrombosis of a synchronous popliteal aneurysm (n ‫؍‬ 2) or for a ruptured iliac aneurysm (n ‫؍‬ 1). Aneurysmectomy with graft interposition between the common femoral and PFA was used in 15 repairs. Ligation alone was used for one aneurysm, and another was treated by partial aneurysmectomy with primary repair. There were no deaths, graft thrombosis, or limb loss at 30 days. At a mean follow-up of 28 months (range, 3 to 108 months), one patient required above knee amputation 2 years after aneurysm ligation, and another patient presented with a recurrent aneurysm. Long-term graft patency was 100%. Conclusions: PFAAs are rare but often occur with synchronous aneurysms. One-third of patients presented with complications of limb ischemia or rupture caused by their PFAA or synchronous aneurysms. Good-risk patients with a PFAA >2 cm should undergo elective repair. Aneurysmectomy with femoral interposition graft is a durable repair.

Cardiovascular Surgery, 1999

In this study, the files of 112 patients with a total of 142 femoral anastomotic aneurysms were reviewed. Eighty-five patients (76%) were initially operated upon for obstructive aortoiliac disease, while the remaining 27 (24%) had abdominal aortic aneurysms repaired. The majority of the patients (104/112) were male and their mean age was 64.5 years (range 45-88). Ninety-three per cent of the subjects were smokers prior to the first operation and 43% continued to smoke at the time of their femoral anastomotic aneurysms operation. The mean delay between the initial surgery and the repair of the femoral anastomotic aneurysms was 74.5 months (range 1-228). The diagnosis was made because of a painless pulsatile mass (91/142), acute leg ischaemia (27/142), a painful pulsatile mass (12/142), haemorrhage (10/142), pseudo-post-phlebitic oedema (1/142) and microemboli of the toes (1/142). The operative mortality was 2.7% (3/112) of which two-thirds were patients with infected grafts. Two subgroups were distinguished: 10 patients with an infected femoral anastomotic aneurysm and 12 patients with recurrent femoral anastomotic aneurysms, 11 with a single recurrence and one with a double recurrence. In the infected group, the time to development of anastomotic aneurysm was shorter than for the group with non-infected femoral anastomotic aneurysms (41 versus 74.5 months) and the operative mortality was 20% (2/10). One patient developed a recurrent femoral anastomotic aneurysm and another was lost to follow-up. Two subsequent deaths occurred, which were unrelated to the femoral anastomotic aneurysms. In the group of recurrent femoral anastomotic aneurysms one patient was lost to follow-up and two patients died, but not as a result of recurrent femoral anastomotic aneurysms. A total of 122 cases underwent interposition of a new prosthetic segment between the proximal prosthesis and the distal artery (89 at the common femoral, 21 at the femoral profundis, eight at the superficial femoral and four at an existing femoro-popliteal graft).

European Journal of Vascular and Endovascular Surgery, 2008

Purpose. To review the pathogenesis, diagnosis, presentation, diagnosis, management and outcomes (morbidity and mortality) of superficial femoral artery aneurysms. Methods. A comprehensive review of this entity was performed based on the available literature in all languages and a detailed discussion of our findings is also provided. Results. Our review identified 61 cases of SFA aneurysms. They were most often seen in elderly men, predominately affected the right lower extremity, and were most often located in the middle-third of the artery. At the time of diagnosis, SFA aneurysms were frequently symptomatic because they reached a relative large diameter before the diagnosis was made. The most frequent presentation was localized pain in association with a pulsatile mass. In contrast to popliteal aneurysms, SFA aneurysms more frequently present with rupture than distal ischemia. Angiography was by far the most commonly utilized diagnostic tool. Treatment was primarily by means of an interposition graft, followed by exclusion and surgical bypass. Endovascular repair of SFA aneurysms has only been reported in three instances. SFA aneurysm repair was most often associated with favorable outcomes, with low reported rates of ischemia and limb loss. Ó

An 82 year-old male patient with the complaints of left leg ischemia and medially located mass on his left lower thigh with diffuse ecchymoses was admitted to the hospital. Two separate aneurysms, one being ruptured, on the left superficial femoral artery were diagnosed by using ultrasonography and angiography. No accompanying aneurysms in the abdominal aorta or other peripheral arteries were found. The patient was undertaken an emergent operation. Resection of aneurysms and ring reinforced PTFE graft interposition was performed after the evacuation of the hematoma. However, necrosis of the left 1st, 2nd and 3rd toes developed during the early postoperative period. The search of the literature revealed three different atherosclerotic aneurysms on the same superficial femoral artery in one patient. Superficial femoral artery aneurysms are usually single and distinctly unusual. Complications such as rupture, thrombosis or embolization may increase mortality and morbidity. Early diagno...

European Heart Journal - Case Reports

Background Isolated true aneurysms in the superficial femoral artery (SFA) have rarely been reported. Most cases are undiagnosed until rupture or the occurrence of complications. Case summary A 36-year-old woman presented with a palpable, pulsating mass on her right thigh which had increased in size over 2 months. She also had a swollen right leg and mild claudication (Stage II in Rutherford classification). For 2 months, the patient was treated by manual massage, acupuncture, and extracorporeal shock wave therapy in local clinics. Bed-side ultrasonography identified a 3.4-cm sized true aneurysm of the right SFA. There were no other aneurysms in arteries from head to toe. There was no evidence of atherosclerotic risk factors or connective tissue disease. The patient was successfully treated by a covered stent graft implantation without any complications. Discussion Isolated true aneurysm in the SFA is rare and tends to go undiagnosed especially in young women. Ultrasonography is an...

International Journal of Surgery Case Reports, 2015

Venous aneurysms are unusual clinical entities that might be difficult to diagnose and usually appear as an asymptomatic incidental finding on physical examination or imaging study and discovered only during the surgical exploration. They are important differential diagnosis of groin and other subcutaneous mass. We report a case of a 67-years-old woman who had a groin mass misdiagnosed as femoral hernia, which was subsequently diagnose as great saphena vein aneurysm in the intraoperative set and treated with ligature and resection. In conclusion, venous aneurysms of the superficial system are lesions that are important differential diagnosis of groin and other subcutaneous mass. Diagnosis is readily available by duplex ultrasonography; however, in most cases, the diagnosis is done only in the operative field.

Scandinavian Cardiovascular Journal, 1975

Cor et Vasa, 2016

Aneurysma hluboké stehenní tepny (deep femoral artery, DFA) se vyskytuje velmi vzácně. Diagnóza se vzhledem k anatomickému uložení tepny stanovuje obtížně. Obecně se aneurysma projevuje komplikacemi-kompresí a rupturou. Popis případu: Popisujeme případ 78letého muže, který byl urgentně přijat na oddělení cévní chirurgie a který si stěžoval na náhlou bolest a velkou pulsující hmotu ve femorálním trojúhelníku levého stehna. Vyšetření ultrazvukem a CT angiografi e (CTA) potvrdily přítomnost prasklého aneurysmatu DFA s velkým hematomem vlevo. CTA prokázala aneurysmata i v obou iliackých, stehenních a lýtkových tepnách. Femoropopliteální segment byl průchodný na obou stranách. Vzhledem k závažnému přidruženému onemocnění byla provedena ligace proximálního krčku aneurysmatu a zašita prasklá stěna. Diskuse: Aneurysmata DFA jsou velmi vzácná-jedná se 0,5 % všech aneurysmat periferních cév. Vzhledem k jejich malému průměru fyzikální vyšetření málokdy prokáže přítomnost aneurysmatu. Mezi cenné diagnostické metody patří duplexní sonografi e a CTA, přičemž druhá metoda je užitečnější, protože prokáže průchodnost a uložení DFA distálně k aneurysmatu. V našem případě nám ruptura aneurysmatu a průchodnost femoropopliteálního segmentu umožnila provést prostou ligaci krčku aneurysmatu a zašití prasklé stěny bez distální rekonstrukce. Závěr: Náš případ potvrzuje přednosti CTA ve srovnání s ultrazvukem při hodnocení postižení vícečetnými aneurysmaty. Výběr způsobu léčby-ligace-byl dán závažným přidruženým onemocněním a průchodností femoropopliteálního segmentu.

European Journal of Vascular and Endovascular Surgery, 2004

Objectives. To review the aetiology and method of treatment of all femoral artery false aneurysms from a single centre during the last 9 years. Design. Retrospective case-note study. Methods. All patients with a diagnosis of false aneurysm were identified from the hospital data-base between January 1995 and September 2003. A manual search of the case-notes was performed, and data collected on the location, cause and method of repair of the false aneurysm. For all patients with a diagnosis of femoral artery false aneurysm, the patients' medical and drug history and admission time attributable to the false aneurysm were recorded. Results. One hundred and seven patients were identified. Seventy-nine had false aneurysms of the femoral artery. The majority (40.5%) were caused by coronary angiography, the second commonest cause being breakdown of previous graft anastomosis (29.1%). Over time, the method of treatment became increasingly radiological (most commonly ultrasoundguided thrombin injection), resulting in a significantly reduced hospital admission time (P ¼ 0.018).

Interactive Cardiovascular and Thoracic Surgery, 2010

To review the experience of our institution in repairing isolated iliac artery aneurysm (isolated IAA) in the last six years.

Jornal Vascular Brasileiro, 2013

Femoral artery aneurysms are rare and generally affect elderly patients. They are often diagnosed in combination with aneurysms in other locations, such as peripheral and aortic aneurysms. This case report describes a young patient whose superficial femoral artery (SFA) had a clinical presentation suggestive of a ruptured aneurysm. The patient underwent standard treatment, with aneurysmectomy and interposition of the ipsilateral saphenous vein. A review of the literature confirms the rarity of this case.

2017

Objective: Primary venous aneurysms are rarely encountered lesions. Case reports have been described throughout the venous system. The lesions are usually symptom-free being found as a subcutaneous mass, an incidental finding on an imaging study, or during the work-up for deep venous thrombosis. However, embolism and rupture have been rarely described. A femoral vein aneurysm is reported, along with a current review of the literature of venous aneurysms. Method: In a 11-year-old healthy female complaining of a localised swelling and pain in her left inguinal region, duplex ultrasonography and angio-computed tomography revealed a giant common femoral vein aneurysmthen Tangential aneurysmectomy and lateral venorrhaphy is performed. Results: Recovery was uneventful and patient still remains asymptomatic. Further duplex ultrasonography revealed patency of common femoral vein without thrombotic changes and no dilatation of the operated vein segment has been observed in the follow-up stud...

Jornal Vascular Brasileiro, 2011

True aneurysms of peripheral arteries should be given attention in view of their low frequency and association with other aneurysms, especially of the abdominal aorta 1. They are more commonly located in the lower extremities and extracranial carotid arteries 1. Although lower limb aneurysms are less common than those of the abdominal aorta, reports on their diagnosis and treatment are found earlier and in larger number in the literature compared to reports on abdominal aortic aneurysms (AAA) 1-3. This is most likely explained by the fact that, at the time of those reports, peripheral aneurysms were more easily diagnosed and surgically approached than AAA 1-3. When it comes to the lower limbs, the popliteal artery is the most common site for aneurysms. Popliteal aneurysms, especially bilateral ones, are frequently associated with AAA. The femoral artery is the second most common site for true peripheral artery aneurysms, while

Polski przeglad chirurgiczny, 2014

Anastomotic aneurysms occurs at various levels of arterial system. Determining their location and incidence rate required investigation of large patient clinical material. In the years 1989-2010 in local centre 230 anastomotic aneurysms were operated in 180 patients. For 187 (81.3%) patients anastomotic aneurysms were localised in the groin, while for remaining 43 (18.7%) they occurred in other localisations. In aortic arch branch they occurred four times (1.7), in descending aorta--three times (1.3%), in abdominal aorta--14 (6.1%) and in iliac arteries--6 (2.6%). While for anastomosis with popliteal artery they were diagnosed in 16 (7%) patients. Own clinical material was compared with literature data. Anastomotic aneurysms in over 80% of cases occur in the groin, remaining percentage corresponds to other localisations.

ANZ Journal of Surgery, 2011