Clinical significance of arteriosclerotic femoral artery aneurysms.

One hundred seventy-two arteriosclerotic femoral artery aneurysms in 100 male patients, 47 to 91 years old, were evaluated. They were bilateral in 72% of the patients, and were associated with aortoiliac aneurysmal disease in 85% and with popilteal artery aneurysms in 44%. Femoral artery aneurysms were asymptomatic in 40 patients. Thirteen patients with thromboembolic episodes and two with rupture had ischemic limbs. Thirty-eight patients underwent primary operation for 50 femoral aneurysms, including 36 lower extremity arterial reconstructions, ten aortofemoral bypasses, one arterial ligation, and three amputations. Two operative deaths occurred, both associated with concomitant aortic surgery. Only three of 105 aneurysms in 58 patients followed nonoperatively were associated with later major limb-threatening complications. The low complication rate attending small, bland aneurysms justified nonoperative management. Large or symptomatic aneurysms warrant early operative intervention.