Ruptured true superficial femoral artery aneurysm

Abstract

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.Keywords: superficial femoral artery; ruptured aneurysm. ResumoOs aneurismas de artéria femoral são raros e ocorrem geralmente em pacientes idosos. Estão frequentemente associados a outros aneurismas, tanto periféricos como de aorta abdominal. O presente relato refere-se a um jovem portador de aneurisma de artéria femoral superficial (AFS), cuja apresentação clínica foi a ruptura. O paciente foi submetido ao tratamento convencional, com ressecção do aneurisma e interposição de veia safena magna ipsilateral. A revisão da literatura corrobora a raridade do caso.Palavras-chave: artéria femoral superficial; aneurisma roto. C A S E R E P O R T Superficial femoral artery aneurysmThese characteristics suggested a ruptured aneurysm of the superficial femoral artery.Arteriography showed that the abdominal and iliac aortas were patent, with no significant obstructions, and that the mid segment of the right superficial femoral artery was dilated. The distal segment showed signs of compression by the adjacent mass and the distal superficial femoral and popliteal arteries had flow, primarily originating in collateral branches (Figures 2, 3 and 4).The patient underwent exploratory surgery of the left lower limb. There was a large-volume hematoma related to the ruptured aneurysm of the left superficial femoral artery ( Figure 5).The aneurysm was resected and the vascular segment reconstructed by reversed interposition of a segment of the ipsilateral saphenous vein (Figure 6). The surgical technique employed was continuous sutures at the arterial anastomoses using 6.0 polypropylene thread. The muscle planes were drawn together using continuous 3.0 nylon thread sutures and skin was sutured with separated 4.0 nylon thread sutures.During the postoperative period, the patient suffered hematoma of the surgical wound and an infection, requiring a second intervention for drainage and surgical debridement, which increased the length of hospital stay and the morbidity related to the procedure. The patient was discharged from hospital 19 days after the first surgery.The patient underwent transesophageal echocardiogram during the postoperative period, with normal results. Fragments of tissue removed during the first operation were sent for microscopic examination and bacteriological tests; but no germ growth was detected. The patient was subjected to rheumatologic tests and the results were negative.

Aneurisma isolado de artéria femoral superficial roto contido: relato de caso

“…Conventional surgical treatment remains the gold standard for peripheral aneurysms, 16,17 with end-to-end anastomosis, venous grafting (preferably with an autologous vein), or prosthetic grafts. 3 In elective cases, patency rates with vein grafts are approximately 80% at 2 years, compared with 65% for polytetrafluoroethylene.…”

A True Bilateral Superficial Femoral Artery Aneurysm: A Case Report

“…True aneurysms of the superficial femoral artery (SFA) are rare and often diagnosed late due to their anatomical location within the thigh [1]. Patients, being mostly of the elderly male population, may present with a pulsating mass in the thigh, pain, venous compression, or be asymptomatic [2].…”

Ruptura espontânea de aneurisma do segmento médio da artéria femoral superficial: relato de caso

“…However, true isolated aneurysms of the superficial femoral artery (SFA) are rare, accounting for approximately 1% of all aneurysms involving the SFA -including false aneurysms -and 0.5% of true peripheral aneurysms. 1,2 In the literature up to 2012, there are reports of 103 cases of true isolated aneurysms of the SFA worldwide, among which the distal third was most frequently involved. 3 Complications associated with SFA aneurysms include thrombosis, distal embolization, and rupture, the last of which is the most frequent.…”

“…Although they are associated with lower rates of complications than other peripheral aneurysms, such as popliteal artery aneurysms, SFA aneurysms should be diagnosed and electively repaired in order to prevent complications. 2,4,5 The objective of this study is to describe treatment of a rare case of rupture of a true aneurysm of the mid third of the SFA and provide a brief review of the literature on the subject.…”