Isolated Superficial Femoral Artery Aneurysm

Figure 1. MRA images showing the segmental occlusion in the middle of the superficial femoral artery in the left lower extremity (small arrow) and the 4.5 cm abdominal aortic aneurysm (large arrow).

A 70-year-old gentleman presented with acute onset of disabling left calf claudication, a more chronic history of persistent left thigh pain, and a palpable firm mass in the medial thigh. He had a history of a nephrectomy for renal cell carcinoma and mild chronic renal insufficiency but was otherwise healthy.

An MRA (Figure 1, 2) revealed a previously undiscovered abdominal aortic aneurysm (AAA) and what appeared to be a short segment superficial femoral artery (SFA) occlusion related to a true, isolated SFA aneurysm. A noncontrast CT scan (Figure 3) confirmed the presence of the SFA aneurysm, which measured 9 cm. We chose to repair the SFA aneurysm with a short segment ePTFE interposition graft (Figure 4) rather than use endoluminal techniques due to the presence of the thigh pain. The AAA measured 4.5 cm and is being observed for now.

Figure 2. The MRA image suggests the presence of the SFA aneurysm in the left lower extremity (arrow).

Figure 3. The noncontrast CT scan confirms the existence of the SFA true aneurysm measuring 9 cm (arrow).

Figure 4. Completion picture shows the ePTFE interposition graft after the SFA aneurysmectomy.