Profunda femoris artery aneurysms: Association with aneurysmal disease and limb ischemia

Abstract

PFAAs are rare but often occur with synchronous aneurysms. One-third of patients presented with complications of limb ischemia or rupture caused by their PFAA or synchronous aneurysms. Good-risk patients with a PFAA >2 cm should undergo elective repair. Aneurysmectomy with femoral interposition graft is a durable repair.

Endovascular Repair of a Large Profunda Femoris Artery Pseudoaneurysm

“…Other symptoms of PFAAs include local compression of surrounding structures such as veins or nerves and thrombosis leading to ischemia and rupture. Moreover, PFAAs can serve as a distal source of emboli [1, 3, 8]. Our patient presented solely with a swelling of the left thigh with an associated palpable thrill.…”

“…In our case, we did not utilize intravenous ultrasound since the sizes of the pseudoaneurysm and the neck were characterized by preoperative CT angiography with 3D reconstruction. Previous studies have shown that 65–75% of PFAAs present with an accompanying aneurysm, namely, popliteal (47%), aortic (33%), and iliac (19%); thus, it would be beneficial to investigate for a PFAA in a patient who presents with an aneurysm elsewhere [1, 2]. Treatment options for PFAA should be geared towards removal of the risk of rupture as well as embolization, pain, and any compromised blood flow to the lower extremities.…”

“…Treatment options for PFAA should be geared towards removal of the risk of rupture as well as embolization, pain, and any compromised blood flow to the lower extremities. Upon diagnosis, the aneurysm should be repaired at the earliest convenience and reasonable recommendations suggest that repair should be considered immediately at a threshold of 2 cm or greater [1, 9]. However, most aneurysms have been and will be found at a size already greater than that since there is no indication to screen for PFAAs.…”

“…PFAAs are mostly asymptomatic and they usually present as an incidental finding. As for symptomatic patients, a swelling in the groin region is the most common presentation [1–3]. True aneurysms of the profunda femoris artery (PFA) are relatively rare (1–2.6%) and are idiopathic in nature without any suggestive cause.…”

Peripheral Artery Aneurysm

“…In a series from Mayo, 11/15 patients (73%) had aneurysms in other locations and rupture occurred in 13%. 11 Again, because of the paucity of data, it is difficult to determine whether these aneurysms are more likely to rupture than others.…”