Rupture of voluminous atherosclerotic superficial femoral artery aneurysm

: Atherosclerotic aneurysms of the superficial femoral artery are very uncommon. We report a case of a ruptured superficial femoral artery aneurysm which was successfully treated surgically, and compare our data with those emerging from a review of the literature. We observed a 74-year-old man who presented with a suspected rupture of a superficial femoral artery aneurysm. After confirmation of the diagnosis with angio-CT, we treated the patient by performing an endoaneurysmectomy and replacing the arterial aneurysmatic segment with interposition of a polytetrafluoroethylene prosthetic graft. There has been no evidence of complications in the short to medium-term. In our review of literature, we collected 43 cases of superficial femoral artery aneurysms. These aneurysms were diagnosed after rupture (30-46%) or thrombosis and embolism (12-46%). Other aneurysms are frequently concomitant (27-69%). The best treatment is based on replacing the aneurysmatic segment with a prosthetic graft which may be autologous (saphenic vein) or heterologous (polytetra-fluoroethylene). In patients with obstructive arteriopathies exclusion of the aneurysm by ligation of the proximal and distal artery may be enough. The high incidence of complications suggests that resection and grafting should be performed electively, and the frequent association with aortoiliac or peripheral aneurysms means that thorough investigation and follow-up are mandatory.