False anastomotic femoral aneurysm associated with multi-aneurysmal disease

Abstract

Anastomotic pseudoaneurysms and true femoral aneurysms are two infrequent arterial entities of low incidence, and together, they are even less common. We present the case of a 71-year-old patient with a history of arterial hypertension who has a history of multiple long-standing vascular interventions: abdominal aortic aneurysm with aorticiliac anastomosis with subsequent femoral-femoral bypass crossed by occlusion of the left branch; and femoropopliteal bypass for left popliteal artery aneurysm. She presents a large pulsatile mass in the left inguinofemoral region without left popliteal and pedal pulses with the viable limbs. The tomographic study showed a pseudoaneurysm of the left common femoral artery with partial thrombosis, dependent on the distal anastomosis of the old femoral-femoral bridge, and a bilateral true fusiform aneurysm of the common and superficial femoral artery with extensive mural thrombosis. It was decided to perform surgery to resect the mixed aneurysmal lesions, perform a right iliac-femoral prosthetic bridge, and replace the crossed femoral-femoral bypass; both included shunts to the deep femoral arteries. With suspicion of thrombosis of the old femoropopliteal bypass, thromboembolectomy of the left leg is performed through the superficial femoral artery, the anastomosis is permeabilized with recovery of the distal pulses.