Ng KaMan, Choi Nim, Deng Hongru, Liang Gangzhu
General Surgery, Conde S. Januário Hospital, Macao, CHN.
Vascular Surgery, Conde S. Januário Hospital, Macao, CHN.
Cureus. 2025 Aug 9;17(8):e89687. doi: 10.7759/cureus.89687. eCollection 2025 Aug.
Spontaneous femoral artery pseudoaneurysms (SFAPs) represent a rare vascular entity. We report the successful hybrid management of a large, wide-necked ruptured SFAP in an 85-year-old male. Computed tomography angiography (CTA) confirmed a massive pseudoaneurysm originating from the distal right superficial femoral artery (SFA) with severe circumferential arterial calcification. Given the prohibitive risks of conventional open repair due to advanced age, comorbidities, and lesion complexity, a hybrid approach was employed: endovascular repair with a self-expanding covered stent, followed by open surgical evacuation of the organized hematoma. This strategy achieved complete pseudoaneurysm repair, effective hematoma evacuation, and preserved distal perfusion without major complications. A brief review of the etiology, diagnostic considerations, and contemporary therapeutic algorithms is provided to contextualize this rare presentation.
自发性股动脉假性动脉瘤（SFAPs）是一种罕见的血管病变。我们报告了一例85岁男性患者，成功采用杂交手术治疗了一个巨大、宽颈的破裂性SFAP。计算机断层扫描血管造影（CTA）证实，一个巨大的假性动脉瘤起源于右侧股浅动脉（SFA）远端，伴有严重的环状动脉钙化。鉴于患者年龄较大、合并症较多以及病变复杂，传统开放修复手术风险过高，因此采用了杂交手术方法：使用自膨式覆膜支架进行血管内修复，随后通过开放手术清除机化血肿。该策略实现了假性动脉瘤的完全修复、血肿的有效清除，并保留了远端灌注，且未出现重大并发症。本文简要回顾了病因、诊断要点和当代治疗算法，以便更好地理解这一罕见病例。
