SUPERFICIAL FEMORAL ARTERY ANEURYSMAL DEGENERATION — SIXTEEN YEARS AFTER SUPERFICIAL FEMORAL ARTERY ENDARTERECTOMY AND VEIN PATCH ANGIOPLASTY

  • Gabriela Teixeira Angiology and Vascular Surgery Department, Centro Hospitalar Universitário do Porto, Oporto, Portugal
  • Joana Martins Angiology and Vascular Surgery Department, Centro Hospitalar Universitário do Porto, Oporto, Portugal
  • Arlindo Matos Angiology and Vascular Surgery Department, Centro Hospitalar Universitário do Porto, Oporto, Portugal
  • Inês Antunes Angiology and Vascular Surgery Department, Centro Hospitalar Universitário do Porto, Oporto, Portugal
  • Carlos Veiga Angiology and Vascular Surgery Department, Centro Hospitalar Universitário do Porto, Oporto, Portugal
  • Daniel Mendes Angiology and Vascular Surgery Department, Centro Hospitalar Universitário do Porto, Oporto, Portugal
  • Carlos Veterano Angiology and Vascular Surgery Department, Centro Hospitalar Universitário do Porto, Oporto, Portugal
  • Henrique Rocha Angiology and Vascular Surgery Department, Centro Hospitalar Universitário do Porto, Oporto, Portugal
  • João Castro Angiology and Vascular Surgery Department, Centro Hospitalar Universitário do Porto, Oporto, Portugal
  • Rui Almeida Angiology and Vascular Surgery Department, Centro Hospitalar Universitário do Porto, Oporto, Portugal
Keywords: Superficial femoral artery aneurysm, Vein aneurysmal degeneration, Superficial femoral artery endarterectomy

Abstract

Superficial femoral artery (SFA) aneurysms are rare clinical disorders, with few case reports and small series published concerning atherosclerotic aneurysms. We report a clinical case a giant aneurysm of the SFA, in a patient previously submitted to extensive SFA endarterectomy and vein angioplasty.
A 73-year-old man presented at a routine vascular surgery consultation. The patient had been submitted to a right SFA endartectomy and vein patch angioplasty, sixteen years ago, for intermittent claudication. Physical examination demon- strated a large pulsatile mass of the right thigh. His right pedal pulse was palpable. Ultrasound and computed tomography scan confirmed a 78x71x240mm aneurysm of the right superficial femoral artery.

He was proposed to aneurysmectomy and femoro-popliteal bypass. During operative intervention, proximal and distal control was obtained and the aneurysm opened. A large amount of thrombus was removed and a femoro-popliteal bypass was performed using the ipsilateral great saphenous vein. The postoperative period was uneventful, as was the patient recovery. In our report, the aneurysmal area matched precisely to the endarterectomised area and no other aneurysms were found. So we are facing an uncommon case of a SFA degeneration into a giant aneurysm after extensive endarterectomy and vein angioplasty.

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References

1. Jarrett F, Makaroun MS, Rhee RY, Bertges DJ. Superficial femoral arteryaneurysms: an unusual entity? J Vasc Surg. 2002 Sep;36(3):571-4.
2. Tao MJ, Al-Jundi W, Roche-Nagle G. Aneurysmal degeneration of vein conduit used for vascular reconstruction-Case report and literature review. Int J Surg Case Rep. 2016;28:289-292.
3. Cassina PC, Hailemariam S, Schmid RA, Hauser M. Infrainguinal aneurysm formation in arterialized autologous saphenous vein grafts. J Vasc Surg. 1998 Nov;28(5):944-8.
4. Cameron DB, Black JH 3rd, Fishman EK, Freischlag JA, Abularrage CJ. Aneurysmal degeneration of the superficial femoral artery after remote endarterectomy. J Vasc Surg. 2012 Apr;55(4):1153-5.
Published
2019-12-27
Section
Clinical Case