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Coronal contrast–enhanced computed tomography image of the aneurysms of the right common femoral artery and both common iliac arteries.
Source publication
True femoral artery aneurysm is a rare vascular entity and is often associated with aortic or peripheral aneurysms. Life-threatening complications associated with peripheral arterial aneurysms include rupture, thrombosis, and embolization. In patients with multiple aneurysms, any symptomatic aneurysms should be treated first; in asymptomatic patien...
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Introduction:
The development of aneurysms in iliac arteries excluded from high-pressure direct flow from the aorta is very uncommon. We report a case of successful treatment of bilateral metachronous iliac artery aneurysms (MIA), found 10 years after an aortobifemoral bypass, with perfusion only by retrograde flow from the common femoral arteries...
Citations
... During the initial presentation, 30-40 % of individuals with isolated true femoral aneurysms are asymptomatic, whereas another 30-40 % experience tenderness and localized pain or compressive symptoms resulting in leg edema and neuropathic pain. Rupture occurs in only around 4 % [11] to 14 % [12] of cases, which is extremely uncommon. Claudication or critical ischemia brought on by embolization is the most frequent presentation of lower extremity ischemia in up to 65 % of patients. ...
Introduction: Tuberculosis (TB) is still a major global health issue. In over 75% of all cases of mycotic aneurysm, TB spreads directly by eroding through the vascular wall. Aortic and innominate arteries are frequently the sites of tubercular aneurysms, primarily due to contiguous dissemination from pulmonary infection sites. We report a case of a saccular aneurysm at the distal common femoral artery associated with tuberculosis.
Case Presentation: A 34-year-old man had the chief complaint of a voluminous pulsatile mass in the left thigh. We found a bruit on auscultation examination at the site of the mass. A computed tomography (CT) angiography showed a saccular aneurysm at the distal common femoral artery and stenosis at the proximal femoral profunda artery. A chest CT scan was conducted, and the result showed a ground-glass appearance and multiple enlarged lymph nodes.
Clinical Discussion: The patient was treated surgically by resection of the aneurysm and reconstruction with an inter-positional saphenous vein graft. Later, he was treated with a drug regimen for tuberculosis by the department of pulmonology. The patient was discharged with no post-operative complications.
Conclusion: Patients with femoral artery aneurysms are at high risk of rupture and death by exsanguination. It can be a severe complication of tuberculosis, especially in immunocompromised patients. Although this was a very rare case, all surgeons must be aware. A combination of medical and surgical intervention is imperative. Careful clinical care postoperatively is mandatory because of the risk of repetitive anastomotic aneurysms and recurrent aneurysms in another vessel.
... 7 Most commonly patients with femoral artery aneurysm present with claudication symptoms or ischemia secondary to distal embolization (65%). 8 Very rarely, cases present with aneurysmal rupture (4%). Diagnosis is most often confirmed with ultrasound or computed tomography with angiography. ...
An 81-year-old male with past surgical history significant for right common femoral to posterior tibial artery bypass as well as aortic aneurysm repair using endograft presented with painful pulsatile right groin swelling. Ultrasound imaging revealed a fluid collection and concern for ruptured right common femoral artery aneurysm with expanding hematoma. The patient underwent prompt aneurysm excision with graft interposition complicated by wound dehiscence for which he subsequently underwent wound exploration, revision of proximal anastomosis and sartorius myoplasty. Our case illustrates a rare form of femoral artery rupture and operative management of a true common femoral artery aneurysm.
... The systematic literature analysis revealed that 19 publications on TPFAA have been made since 2012 (Table). [1][2][3][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] The 19 publications identified (2012-2019) included 18 case reports and one cadaver study in which a donated body was found to have true profunda femoris aneurysms. 21 This case report demonstrated the rare double TPFAA. ...
... Among studies published from 2012, the common cause of TPFAA was atherosclerotic wall degeneration. [1][2][3][7][8][9][10][11][12][13][14][15][16][17][20][21][22] Other causes included pre-vasculo-Behçet status 19 and physical injury during play fighting, 18 cases that occurred in patients aged 34 years and 31 years, respectively, suggesting that TPFAAs are mainly due to vascular wall degeneration among the aged. The clinical presentation of patients with ruptured TPFAA included pain, swelling, paresthesia, walking impairment, edema, and paralysis. ...
Objective:
True profunda femoris artery aneurysm (TPFAA) is rare. Most cases of profunda femoris artery aneurysm are classified as pseudoaneurysms. TPFAAs are mostly asymptomatic, but some are manifested with pain, swelling, paresthesia, gait and movement disturbances, thrombosis, and rupture. There is a paucity of evidence on the effectiveness of diagnostic and therapeutic measures for management of TPFAA. The aim of this paper was to systematically review the incidence, diagnosis, and management of TPFAA.
Methods:
A comprehensive systematic review on the diagnosis and management of TPFAAs was conducted by a search through PubMed, Cochrane, Embase, and Google Scholar databases to identify and to evaluate publications on TPFAA since 2012. Only publications on TPFAA were included in this review.
Results:
A total of 19 publications published from 2012 were included in the review. The studies were 18 case reports and a cadaver study reporting 27 TPFAAs in 26 patients with a mean age of 69.6 years. Rupture was reported in 18.5% of the cases (n = 5); the conventional clinical presentation of unruptured TPFAA was reported in 48% of cases (n = 13), with 40.9% of unruptured aneurysms being asymptomatic (n = 9). Computed tomography angiography was used as a diagnostic tool in 85.2% of the cases (n = 23); Doppler ultrasound was applied in 33.3% of cases (n = 9). The common therapeutic approaches were resection and revascularization (n = 13 [48.1%]) and ligation or resection without reconstruction (n = 6 [22.2%]). Cumulative analysis for cases reported before and after 2012 yielded similar results.
Conclusions:
Review of the current literature supports that computed tomography angiography and Doppler ultrasound are the mainstay diagnostic approaches for TPFAA. Surgical repair through ligation, resection, and revascularization remains the most common and effective therapeutic procedure. Endovascular embolization is recommended for aneurysms when surgery is not tenable because of the patient's comorbidities and the aneurysm's anatomy.
