Surgical Treatment for Profunda Femoris Artery Aneurysms: Five Case Reports

Abstract

Profunda femoris artery aneurysm (PFAA) is an extremely rare entity, with most cases being asymptomatic, which makes obtaining an early diagnosis difficult. We herein report a case series of PFAA, in which more than half of the PFAAs, which presented with no clinical symptoms, were discovered incidentally. All PFAAs were treated surgically with aneurysmectomy with or without vascular reconstruction. In cases involving a patent superficial femoral artery (SFA), graft replacement of the profunda femoris artery (PFA) is not mandatory; however, preserving the blood flow of the PFA is necessary to maintain lower extremity perfusion in patients with occlusion of the SFA. Therefore, the treatment of PFAAs should include appropriate management of both the aneurysmectomy and graft replacement, if possible.

Profunda femoris medial circumflex branch aneurysm: A case report

“…Femoral artery pseudoaneurysm has been well-documented in the literature following hip replacement surgery. [6] However, on intraoperative examination, the aneurysm was found to be a true aneurysm. A non-ruptured aneurysm would maintain all layers of the arterial wall, which was what was encountered during surgery, at least macroscopically.…”

“…However, higher thresholds for intervention were advocated by other authors. [6] Lawrence et al [7] suggested a 3.5-cm threshold for repair of pooled femoral artery aneurysms. However, in their study, most of the patients had CFA or superficial femoral artery aneurysms and, therefore, the results should be viewed cautiously in case of PFAAs.…”

Reconstruction for rupture of profunda femoris artery aneurysm in a patient with sarcopenia

“…Some studies have reported that if the ipsilateral femoropopliteal lesion is patent without stenosis, the ligation may be sufficient [ 4 , 8 , 9 ]. However, Igari et al argued that PFAA should be treated with both aneurysmectomy and vascular reconstruction to preserve the PFA blood flow, which may positively affect future limb salvage [ 10 ]. We agree that reconstruction should be performed if the general condition is good.…”

Successful treatment of a rare 6.5-cm true profunda femoris artery aneurysm with aneurysmectomy and interposition bypass

“… 1 , 3 True aneurysms of the PFA are usually asymptomatic, but can present as a painful pulsatile groin mass. 2 , 4 , 5 Due to the nonspecific nature of the presenting symptoms, diagnosis is often delayed. Physicians need to have a high index of suspicion to prevent complications, which can include compression of surrounding structures, distal embolization, and rupture.…”