Pseudoaneurysm of the superficial femoral artery after closed hip nailing with a Gamma nail: report of a case

Pseudoaneurysm of the femoral artery after internal fixation of a trochanteric fracture is caused primarily by overpenetration of the drill bit or screws. We report a case of pseudoaneurysm of the superficial femoral artery after insertion of a Gamma nail. A probable cause for this injury is adduction and internal rotation of the involved limb. During the distal interlocking procedure, this maneuver endangers the superficial femoral artery by abutment of the femoral vessels to the femur. It is recommended that the limb be placed in a neutral position during preparation of the interlocking hole.     

Pseudoaneurysm of the superficial temporal artery following craniotomy--case report

A 48-year-old male without marked blood coagulation disorder developed a pseudoaneurysm of the superficial temporal artery (STA) following craniotomy. Cerebral angiography revealed a pseudoaneurysm on the parietal branch of the STA. Total extirpation was performed, and the postoperative course was uneventful. Most pseudoaneurysms of the STA develop after trauma. Lesions rarely develop after craniotomy. However, pseudoaneurysm of the STA should be considered as a possible surgical complication.     

Pseudoaneurysm of the superficial femoral artery after retrograde intramedullary nailing for a supracondylar femoral fracture

Vascular complications of distal femoral fractures are rare but can have disastrous consequences if not recognised and treated promptly. We present the case of a 55-year-old woman who developed a pseudoaneurysm of the superficial femoral artery after osteosynthesis to repair a supracondylar femoral fracture. Eight weeks after surgery, swelling of the right thigh persisted and was accompanied by severe pain. Enhanced computed tomography revealed a pseudoaneurysm in the medial aspect of the affected thigh. Open surgical repair was performed by direct arterial suture. Although the true aetiology of the development of the pseudoaneurysm is unknown, a bony fragment from the reduction manoeuvre may have damaged the adventitia of the superficial femoral artery. In cases of continuous thigh swelling after osteosynthesis to repair a supracondylar femoral fracture, a diagnosis of pseudoaneurysm should be considered and treatment should be initiated immediately.     

Peroneal artery approach for angioplasty of the superficial femoral artery: a case report

The authors report the implantation of a Palmaz stent in the superficial femoral artery using an approach not previously described, the peroneal artery. A 64-year-old man was admitted with extensive necrosis of the right foot. Physical examination showed a normal right femoral pulse but absence of popliteal and tibial pulses. Arteriography showed a superficial femoral artery with critical stenoses but a normal profunda artery. A classic below-knee amputation was performed. During the procedure, the muscular blood flow was considered insufficient, by clinical experience, to achieve limb healing at this level, and so the surgeon chose to perform an angioplasty of the superficial femoral artery lesion, utilizing an access through the leg arteries. After introducing the guidewire through the peroneal artery, the surgeon successfully dilated the lesion and implanted a Palmaz stent. Afterward, the popliteal pulse became palpable in physical examination and improved the skin and muscular aspect in this level. The surgery was finished with a closed stump. The surgery healed satisfactorily, without any complications, and the patient had a satisfactory follow-up, with ambulatory rehabilitation, and recovery of walking capacity with a leg prosthesis. The peroneal approach gave satisfactory results and should be considered in clinical situations like this.     

Rupture of infected superficial femoral artery aneurysm. A case report

A case of misdiagnosed infected superficial femoral artery aneurysm is presented. It was initially misdiagnosed as thrombophlebitis. Surgical excision and repair with a saphenous vein interposition graft was performed. The diagnosis of this disease is difficult because there is a lack of signs and symptoms. Staphylococcus aureus and enterobacter are the two most common organisms responsible for infected peripheral aneurysms. Surgery is the standard treatment: ligation, drainage and resection with or without arterial reconstruction depending upon the aneurysm localization.     

Rupture of an isolated true superficial femoral artery aneurysm: case report

True isolated atherosclerotic aneurysm of the superficial femoral artery is a rare pathology. We report a case of ruptured superficial femoral artery aneurysms (SFAA) not associated with aortic, common femoral or popliteal artery aneurysms. An emergency surgical procedure was performed and, after endoaneurysmal branches ligation, a ePTFE graft interposition was performed. The literature review shows a prevalence of rupture as compared with ischemic complications and the need for surgical repair in case of SFAA with diameter twice the normal vessel size. Early diagnosis and management are recommended because of the lower morbility and mortality rates associated with elective surgery by comparison with emergency procedures.     

Native superficial femoral artery peripheral atherectomy site pseudoaneurysm: a case report

A 45-year-old woman who presented with blue toe syndrome was treated with atherectomy for a focal plaque located in the superficial femoral artery. She subsequently developed a large pseudoaneurysm at the atherectomy site requiring multiple sequential endovascular procedures in order to maintain in-line blood flow to the foot. Pseudoaneurysm formation at native peripheral artery atherectomy site has not been reported previously. We discuss possible complications of atherectomy and the possible mechanism of pseudoaneurysm formation after atherectomy. We address the importance of understanding risks of these minimally invasive procedures along with planning follow-up duplex and potential bail-out tactics.     

Pseudoaneurysm of the extracranial vertebral artery; a case report

Traumatic injury of the vertebral artery is rare and only a few reports have been presented. We treated a case of iatrogenic pseudoaneurysm of the extracranial vertebral artery. A 65-year-old man complained of headache and had a pulsating mass in the soft tissue of the neck which had continued for one month after evacuation of hypertensive cerebellar hemorrhage. The left VAG revealed a large pseudoaneurysm at the third portion of the vertebral artery and the right retrograde VAG revealed agenesis of the vertebral artery. To select the proper treatment was a dilemma. This case was treated by embolization using an occluding spring embolus with direct transcutaneous puncture of pseudoaneurysm. Following this treatment, the mass and associated symptoms resolved without neurological deficit.     

A rare case of aneurysm of the superficial femoral artery with dysplasic etiology

The most frequent localisation of fibrous dysplasia of the arteries is at the renal arteries. Other localisations are rarer and those at the femoral as in the case described are exceptional. The case was observed in a 21-year-old woman who, in the absence of any previous traumatism and septic state, noticed the onset of a pulsating tumefaction at thigh level. Echography and arteriography showed the tumefaction to be an aneurysm of a collateral of the superficial femoral artery at the lower IIIrd of the thigh with the dimensions of a pigeon's egg. The aneurysm was successfully removed without the need for grafts and subsequent histological examination showed it was secondary to fibrous dysplasia. The rarity of such a clinical case is stressed.     

Ruptured atherosclerotic aneurysm of the superficial femoral artery. Case report

Aneurysms of the superficial femoral artery are rare. A case of multiple superficial femoral artery aneurysms, of which one ruptured, is described. After surgical treatment the prognosis is favourable, but without therapy the risks of rupture, thrombosis or embolization are great.     

Giant true aneurysm of superficial femoral artery in patient with multiple atherosclerotic aneurysms: A case report

True atherosclerotic aneurysms of superficial femoral artery (SFA) are rare and often associated with other peripheral or aortic aneurysms.We report the case of a 84-year-old patient presenting a giant degenerative ruptured aneurysm of the superficial femoral artery. The patient underwent successful aneurysm resection and bypass grafting, with a satisfying long-term follow-up and patency of the graft. The patient was also operated one year before, for a ruptured aneurysm of the abdominal aorta.This case report is rare, because we described a case of patient with multiple atherosclerotic aneurysms, who present, for the second time, a life threating ruptured aneurysm. In this report, we see extreme and rapid evolution of SFA Aneurysm before being symptomatic.Degenerative aneurysms of the lower extremity most commonly involve the popliteal artery, while they are rarely detected in the femoral region (Leon et al., 2008). In this region, aneurysms most frequently involve the common femoral artery (CFA), whereas true aneurysms of the superficial femoral artery (SFA) represent only 15% to 25% of femoral arterial aneurysms [1], [2], [3], [4], [5].Degenerative aneurysms of the SFA display peculiar characteristics (in terms of clinical onset, diagnostic timing, and clinical behavior) so that they differ from other peripheral aneurysms. Because the relative rarity of this location, our case report can be useful to participate to increase the number of reported cases, and define the therapeutic approach for this rare location.     

Pseudoaneurysm of the popliteal artery with an unusual arteriographic presentation. A case report

Pseudoaneurysms caused by osteochondromas during the second decade of life are well known. Arteriography is generally helpful in the diagnosis of a false aneurysm. In a 30-year-old man, the case was unique in that the arteriogram failed to show the aneurysm at all. Physical examination revealed yellow discoloration and tiny hemangiomas of the skin over the fossa poplitea. More emphasis should be placed on the physical examination and less on the arteriogram in making a correct diagnosis.     

Pseudoaneurysm complicating superficial temporal artery--middle cerebral artery bypass

A patient with transient ischemic attacks from occlusion of a left common carotid artery was treated with common carotid endarterectomy immediately followed by superficial temporal artery-middle cerebral artery bypass. Subsequent angiography demonstrated a pseudoaneurysm formation at the anastomotic site. To our knowledge, this is the first report of this complication occurring in a human being.     

Pseudoaneurysm complicating superficial temporal artery-superior cerebellar artery bypass

A 60-year-old man with vertebrobasilar ischemia unrelieved by anticoagulation was found to have a midbasilar stenosis with an inadequate basilar collateral circulation. He underwent a right superficial temporal-superior cerebellar artery bypass. Following this operation he had a subarachnoid hemorrhage and right third nerve palsy that was due to formation of a pseudoaneurysm at the site of the anastomosis. This aneurysm was managed by ligation of the right superficial temporal artery. Subsequently it became necessary to perform a left superficial temporal artery-superior cerebellar artery bypass because of severe posterior circulation ischemic symptoms.     

Pseudoaneurysm of the splenic artery fistulized in the stomach and associated to a pancreatic pseudocyst: case report

A case of pseudoaneurysm of the splenic artery fistulized in the stomach and associated to a pancreatic pseudocyst is presented. A diabetic and alcoholist 40-year-old man was referred for gastrointestinal bleeding. Esophagogastro-duodenoscopy showed a tumefaction of the little gastric curve and a gastric bleeding fistula. A computed tomography demonstrated a pseudoaneurysm of the splenic artery fistulized in the stomach and associated to pancreatic pseudocyst. Marsupialization of the pancreatic pseudocyst, ligature of the splenic artery, splenectomy and closure of the gastric bleeding fistula were performed. There were no postoperative complications and the follow-up showed no other complications. Aneurysms and pseudoaneurysms of the splenic artery are very frequent, generally asymptomatic (70% of the cases) and in half of the cases they are occasionally diagnosticated. The bleeding of pseudoaneurysm for rupture or fistulization is a very rare and serious complication associated to a high percentage of mortality.     

Gunshot injury of superficial femoral artery. Surgical treatment without preoperative angiography: a case report

The superficial femoral artery is the most frequently injured vessel in lower limb traumas. The traumatic agents responsible may be gunshot, blunt instrument and stab wounds. Preoperative angiography is often used to choose the most appropriate surgical approach for limb salvage. We report a case of a traumatic gunshot lesion of the superficial femoral artery surgically treated with a great saphenous vein bypass without preoperative angiography.