Arteriosclerotic femoral artery aneurysms. A short review.

True arteriosclerotic aneurysms of the femoral artery are rare but they are dangerous lesions that may thrombose, embolise or rupture. They are often bilateral and frequently the patient has other aneurysms in the abdominal aortic or popliteal artery. True femoral aneurysms were originally classified by Cutler and Darling in 1973 as type 1 and type 2 according to their relationship to the common femoral bifurcation. Case reports of isolated superficial and profunda femoral artery aneurysms have been published, but these are exceedingly rare although isolated aneurysms of the profunda femoris artery may be more common in Denmark. True femoral artery aneurysms are attributed to weakening of the arterial wall due to atherosclerosis. True femoral artery aneurysms are relatively rare and are found in elderly smoking men. Aortic aneurysms are approximately 10 times more common. Distal embolization occurs in 0-26% of cases. Acute thrombosis occurs in around 15% of cases. Rupture is uncommon and varies between 10% and 14%. Aneurysmal dilatation of the profunda femoris artery is uncommon and occurs in only 1% to 2.6% of all femoral artery aneurysms. Individualized operative approaches are based on aneurysmal involvement of the superficial femoral or profunda femoris arteries, as well as the presence or absence of coexisting extremity occlusive disease. Aneurysm excision and interposition or bypass graft reconstruction are favored over direct end-to-end reanastomosis.