A Rare Late Term Complication of Vascular Surgery: True Common Femoral Artery Aneurysm

Abstract

Femoral artery aneurysm is a rarely seen peripheral aneurysm which may lead to thrombosis, embolism and fatal rupture in untreated cases. Although femoral artery aneurysm is usually caused by atherosclerosis or chronic inflammation, aneurysm formation in sites of anastomosis, grafts or endarterectomy territory may occur at late term. A 57-yearsold man presenting with stable angina pectoris was admitted for coronary angiography with documented ischemia in exercise stress test. The patient had a history of left femoral thromboendarterectomy and venous patch plasty five years ago. Physical examination revealed a pulsatile mass in the left groin. Coronary angiography revealed a distal circumflex artery lesion and follow up with optimal medical treatment was planned for coronary artery disease. Afterwards, a lower extremity arteriography was performed which indicated a true aneurysm of the left common femoral artery (CFA). The aneurysm was at the site of previous endarterectomy and patch plasty pointing out an iatrogenic etiology. A multidetector computed tomography (MDCT) angiography was performed to rule out any other arterial aneurysms and confirm the relation of the aneurysm and deep femoral artery bifurcation. Treatment with surgical repair was planned since the aneurysm was covering the bifurcation and had iatrogenic etiology.