A Case of Hybrid Therapy for Deep Femoral Artery Aneurysm in a Frail Older Patient

Abstract

An 89-year-old man complained of pulsatile masses in his right groin. Computed tomography (CT) scans revealed an aneurysm of the right deep femoral artery. He was admitted to our hospital with a diagnosis of deep femoral artery aneurysm (DFAA). The clinical frailty scale score was 6 (moderately frail), and he also suffered chronic obstructive pulmonary disease (COPD). Considering his complicated frail and impaired pulmonary function, conventional graft replacement and aneurysmectomy were thought to be quite a high risk. Thus, we selected endovascular treatment. It was not possible to secure a sufficient proximal landing zone for measurement, we did not select a stent-graft treatment. Therefore, we performed hybrid therapy with proximal neck ligation and distal outflow coil embolization. The postoperative course was uneventful, and CT disclosed complete occlusion of the aneurysm.