Ruptured true superficial femoral artery aneurysm

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.

Il Giornale di chirurgia, 2005

True isolated atherosclerotic aneurysm of the superficial femoral artery is a rare pathology. We report a case of ruptured superficial femoral artery aneurysms (SFAA) not associated with aortic, common femoral or popliteal artery aneurysms. An emergency surgical procedure was performed and, after endoaneurysmal branches ligation, a ePTFE graft interposition was performed. The literature review shows a prevalence of rupture as compared with ischemic complications and the need for surgical repair in case of SFAA with diameter twice the normal vessel size. Early diagnosis and management are recommended because of the lower morbility and mortality rates associated with elective surgery by comparison with emergency procedures.

Scandinavian Cardiovascular Journal, 1975

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 Journal of Vascular and Endovascular Surgery, 2000

Introduction Ultrasound evaluation and angiography revealed a 6 cm SFAA. In the theatre a ruptured aneurysm of the Superficial femoral artery aneurysms (SFAAs) are distal superficial femoral artery (SFA) was confirmed. Total resection of the SFAA was performed and a 10-rare. 1 Atherosclerotic SFAAs usually remain undetected until rupture takes place, 2 in contrast with cm-long 6-mm polytetrafluoroethylene (PTFE) graft was interposed. Ligation of the popliteal vein was also aneurysms of the common femoral and popliteal artery whose rupture is distinctly uncommon. 3-5 Infected necessary. He was discharged 5 days later in good condition. SFAAs have a high tendency to rupture. The physician must be aware of their development in patients with bacteraemia, keeping in mind that their clinical presentation may sometimes be obscure. 6 During the period 1990 to February 1999, 153 Case 2 patients were operated on for aneurysmal disease in our institution, including two patients with SFAA, A 66-year-old male was admitted with a suspected giving an incidence of 1.5%. The first patient presented deep venous thrombosis. Thirty days before admission with rupture of an atherosclerotic aneurysm and the he had a urinary tract infection, due to Escherichia coli. second one with simultaneous rupture of bilateral Twenty days later he developed pain and swelling in SFAAs. We report our experience in the management both lower limbs with persistent fever, despite the of SFAAs and the use of prosthetic grafts in infected antibiotic therapy. aneurysms, where the traditional practice demands On physical examination, the patient was pale and avoidance of such a material. A review of the literature had a low-grade fever. Tender, erythematous, pulsatile regarding SFAAs is also presented. masses were detected on the anteromedial aspect of both lower thighs. The calves were normal, distal pulses were present and the rest of the physical ex-Case 1 amination was unremarkable. Ultrasound evaluation revealed bilateral SFAAs with a small area of peri-An 81-year-old male with a known abdominal aortic aneurysmal leakage. Deep venous thrombosis was not aneurysm was admitted with a pulsatile haematoma present. Laboratory tests revealed a white blood cell in his left thigh that had progressively expanded durcount of 17 800/mm 3 and a haemoglobin concentration ing the previous 4 days. He was haemodynamically of 7.5 g/dl. A few hours after admission the rightstable. On physical examination a pulsatile haematoma sided aneurysm ruptured, causing an expanding with visible bruising was present in the posterior and haematoma in the posterior thigh. Emergency exmedial aspect of his left thigh up to the buttock. ploration through a medial approach confirmed the presence of a 6-cm ruptured aneurysm in the lower segment of SFA. The aneurysm had a wide neck

Vascular and Endovascular Surgery, 2020

Atherosclerotic true aneurysms of the superficial femoral artery (SFA) and profunda femoris artery (PFA) are rare and difficult to detect. The synchronous presence of SFA and PFA aneurysms is even rarer. Herein, we present a case with ipsilateral true SFA and PFA aneurysms diagnosed with rupture. A review of the international literature is made, and the diagnosis and treatment options of this rare condition are discussed. A 75-year-old male was admitted to our hospital with an aneurysm on the distal SFA and the ipsilateral PFA, as well as a hematoma around the PFA. It was difficult to determine the source of the rupture before surgery, even with proper imaging. Successful ligation of the PFA and an aneurysmectomy followed by a bypass grafting for the SFA were performed. An intraoperative examination revealed that the SFA aneurysm had ruptured. In elderly males with a history of ectasia or aneurysm on the aorta or peripheral arteries, a synchronous aneurysm on the SFA or the PFA shou...

Journal of Vascular Surgery, 2011

Background: The purpose of this experience was to define patient characteristics, aneurysm anatomy and presentation, types of utilized repair options, and temporal changes over 2 decades in the management of femoral artery aneurysms (FAAs). Methods: Between January 1988 and December 2009, 27 patients with a total of 35 true FAAs were analyzed. Histologic examination was obtained for all the operated FAAs. Postoperative follow-up included clinical and radiologic examinations every 6 months in the first year and once per year thereafter. Results: There were 25 men; mean age was 65 ؎ 19 years. Aneurysms involved the common femoral artery in 20 cases (57%), the superficial femoral artery in 9 cases (26%), and the profunda femoris artery in 6 cases (17%). Seven patients (26%) had bilateral aneurysms, and 13 patients (48%) had additional aneurysms. Overall, 10 FAAs (29%) were symptomatic. Mean aneurysm diameter was 46 ؎ 19 mm. Three patients with four aneurysms were not operated on, and 31 aneurysms were finally operated on. Intensive care unit admission was never needed and hospital mortality was not registered. Major complications occurred in 3 cases (3 of 31; 8.5%) only. Amputations were never performed. Mean follow-up was 56 ؎ 49 months. No graft thrombosed and only a late (6 months) anastomotic pseudoaneurysm was detected and treated with an endograft. Patients' survival was 93% ؎ 0.5% at 6 months, 88.6% ؎ 0.6% at 1 year, and 77.6% ؎ 1.2% at 5 years. Conclusion: FAAs have been uncommon and rarely isolated lesions. Surgical repair offered good results either in elective or urgent settings. ( J Vasc Surg 2011;53:1230-6.)

2021

Background: Aneurysm of the peripheral artery is a rare vascular pathology, especially aneurysm in the common femoral artery. Here, we presented a case report of a right common femoral artery aneurysm caused by infection. Objective: This case report is aimed to explore further about the diagnosis process of rare cases in peripheral arteries to elaborate proper treatment for patients with this condition. Case Presentation: a 76-year-old man was referred to our hospital with a pulsatile groin mass at his right thigh. He had no prior history of surgery or traumas, but he has been treated in a private hospital due to septic condition, hypertension, and type II diabetes mellitus. A diagnosis of a common femoral artery aneurysm was made based on findings from physical examination and radiology examination. The patient was referred to the Cardiovascular and Thoracic Surgeon Department and scheduled for routine surgery, but on the third day of admission patient became hemodynamically unstab...

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...