Surgical Treatment for an Atherosclerotic Aneurysm of the Superficial Femoral Artery: Report of a Case

Abstract

We report the case of an isolated atherosclerotic aneurysm of the superficial femoral artery (SFA). The patient was a 76-year-old man who presented with intermittent claudication and muscle weakness in his right leg. Angiography showed an aneurysm in the lower portion of the right SFA, but no abdominal aortic aneurysm or any other peripheral aneurysms were detected. The patient had not suffered any major complications such as rupture, thrombosis, or distal emboli by the time of presentation. Thus, we resected the aneurysm and replaced it with a Dacron graft. Pathological examination revealed typical atherosclerotic changes and no evidence of infection, previous injury, or connective tissue disorders. While isolated atherosclerotic aneurysms of the SFA are rare, with only about 30 cases documented, patients frequently present with major complications and therefore, making an early diagnosis and initiating appropriate surgical treatment are essential.

Surgical management of isolated superficial femoral artery degenerative aneurysms

“…Other reported symptoms are the presence of a pulsatile mass in the thigh, pain, DVT, lower limb edema, claudication, or bruising. 10,18 The high incidence of complications suggests that repair should be performed electively when possible.…”

Degenerative Aneurysms of the Superficial Femoral Artery

“…In addition, there is evidence for the existence of a genetic predisposition to true aneurysm formation in the femoral arteries, in view of the demonstrated association of femoral aneurysms with abdominal aortic aneurysms. 2 For that reason, all patients diagnosed with femoral aneurysms should 13 7 PTFE interposition graft, 8 mm Siani 2005 14 9 PTFE interposition graft, 8 mm Troitskky 2005 15 8.5 Viabahn stent-graft Honjo 2004 6 8 Dacron interposition graft, 8 mm Dobritz 2003 16 9 Femoropopliteal bypass, vein Jarrett 2002 17 6.5 ˆPTFE interposition graft Jarrett 2002 17 6.5 ˆPTFE interposition graft Jarrett 2002 17 6.5 ˆAmputation Jarrett 2002 17 6.5 ˆPTFE interposition graft Jarrett 2002 17 6.5 ˆDacron interposition graft Jarrett 2002 17 6.5 ˆProsthetic interposition graft Jarrett 2002 17 6.5 ˆFemorotibial bypass, vein, in situ Jarrett 2002 17 6.5 ˆDacron interposition graft Jarrett 2002 17 6.5 ˆDacron interposition graft Jarrett 2002 17 6.5 ˆFemoropopliteal bypass, vein, in situ Jarrett 2002 17 6.5 ˆAmputation Papadoula 2000** , 18 6 PTFE interposition graft, 6 mm Dimakakos 1998 11 8 PTFE interposition graft, 8 mm Dimakakos 1998 11 6 PTFE interposition graft, 8 mm Atallah 1995 19 15 PTFE interposition graft, 6 mm Atallah 1995 19 10 Resection Diethrich 1995 20 18* Endoluminal PTFE customized graft Diethrich 1995 20 40* Endoluminal PTFE customized graft Farinon 1995 21 10 PTFE interposition graft, 8 mm Vasquez 1993 22 3.5 PTFE interposition graft, 8 mm Masegosa 1992 23 15 Femoropopliteal bypass, vein, reversed Rigdon 1992 2 12 PTFE interposition graft, 8 mm Rigdon 1992 2 5 PTFE interposition graft, 8 mm Bonelli 1991 24 NR Femoropopliteal bypass, PTFE Bonelli 1991 24 NR Femorotibial bypass, vein, in situ Mayall 1991 25 NR Endoaneurysmorraphy Mayall 1991…”

“…5 Two reviews together comprising 208 arteriosclerotic femoral artery aneurysms did not include any instances of SFA involvement, 3,4 and only 30 instances of SFA aneurysms have been reported until 2004. 6 The distribution of aneurysms in the thigh has been calculated as follows: 80% common femoral, 15% SFA and 5% the profunda femoris artery. 7 Aetiologic factors include atherosclerosis, syphilitic and mycotic infections, non-infectious immunologic or inflammatory arteritis, connective tissue disorders (Adamantiades-Behcet's syndrome, 8 periarteritis nodosa, Takayasu's disease and Marfan's syndrome 9 ), human immunodeficiency virus 10 and trauma.…”

“…11 The relative rarity of SFA aneurysms has been attributed to the protection provided by the surrounding musculature and the lack of bending stress. Since this entity is rare, its natural history unknown, and because its recognition is expected to increase due to better surveillance of the aging population and more widespread availability of improved vascular imaging modalities, 6 we elected to perform an exhaustive analysis of the available literature on SFA aneurysms to answer specific questions regarding their demographic features, presentation, diagnosis, management and outcomes.…”

Giant true aneurysm of superficial femoral artery in patient with multiple atherosclerotic aneurysms: A case report

“…Other reported symptoms are the presence of a pulsatile mass in the thigh, pain, deep venous thrombosis, lower limb edema, or claudication. or bruising [7], [13].…”