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PVSS17.  Profunda Femoris Artery Aneurysms: Association With Aneurysmal Disease And Limb Ischemia

Catalin Harbuzariu, Audra A. Duncan, Thomas C. Bower, Manju Kalra, Peter Gloviczki.
Mayo Clinic, Rochester, Minn.

OBJECTIVES: As there is a paucity of data about management and outcome of true profunda femoris artery aneurysms (PFAA), we reviewed our 21-year experience with surgical repair of PFAA.

METHODS: Clinical data of all patients (n=15) who underwent repair between 1985 and 2006 were retrospectively reviewed.

RESULTS: Fifteen men had 17 PFAAs with a mean diameter of 3.4 cm. Three had acute presentation with rupture (n=2) or acute limb ischemia (n=1), one had local tenderness and 11 were asymptomatic. Sizes of the ruptured PFAAs were 1.5 and 7.5 cm. Eleven (73%) of patients had synchronous aneurysms, most frequently in the popliteal artery (n=7). Three of the asymptomatic patients required an emergent operation because of acute lower extremity ischemia caused by thrombosis of a synchronous popliteal aneurysm (n=2) or for a ruptured iliac aneurysm (n=1). Aneurysmectomy with graft interposition between the common femoral and PFA was used in 15 repairs. Ligation alone was used for 2 aneurysms. Mortality, graft thrombosis and limb loss at 30 days were 0. At a mean follow-up of 28 months (range 3-108), one patient required above knee amputation 2 years after aneurysm ligation and another patient presented with a recurrent aneurysm. Long term graft patency was 100%.

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