Cor Vasa 2017, 59(5):e488-e492

A rare case of multiple aneurysms in ilio-femoro-popliteal segment with rupture of deep femoral artery

L. Beshev^a, T. Andreev^b,*, A. Marinov^a, N. Totsev^b, V. Velikov^a, B. Tsankov^a, B. Ignatov^a

^a Department of Vascular Surgery, Medical University of Pleven, University Hospital of Pleven, Pleven, Bulgaria

^b Department of Radiology, Medical University of Pleven, University Hospital of Pleven, Pleven, Bulgaria

Introduction: Aneurysms of the deep femoral artery (DFA) are extremely rare. The diagnosis is difficult due to the anatomical location of the artery. Generally, the aneurysm presents itself with its complications - compression, rupture.
Presentation of case: We present a case of 78-year-old man admitted in state of emergency in Vascular Surgery department, presenting with suddenly appearing pain and big pulsatile mass in the femoral triangle of the left thigh. The performed ultrasonography and CTA confirmed the presence of ruptured DFA aneurysm with big hematoma on the left side. CTA established also aneurysms of both iliac, femoral and popliteal arteries. Femoro-popliteal segment was patent at both sides. Due to the severe comorbidity, the performed procedure was ligation of the proximal neck of the aneurysm and suturing the ruptured wall.

Discussion: The aneurysms of the DFA are very rare - 0.5% of all aneurysms of the peripheral vessels. Due to the small diameter physical examination rarely establishes the presence of aneurysm. Valuable methods for diagnosis are duplex ultrasonography and CTA. More important is the latter because it shows the patency and location of the DFA, distally to the aneurysm. In our case rupture of the aneurysm and patency of the femoro-popliteal segment allowed us to do simple ligation of the aneurysmal neck and suturing the ruptured wall, without distal reconstruction.

Conclusion: Our case confirms the value of CTA over ultrasonography in the estimation of the multi aneurysmal disease. The choice of treatment method - ligation, was determined by the severe comorbidity and patency of the femoro-popliteal segment.

Received: May 22, 2016; Revised: July 28, 2016; Accepted: August 2, 2016; Published: October 1, 2017  Show citation