Aneurismas verdaderos de la femoral superficial: a propósito de un caso

Introduction. True aneurysms of the superficial femoral artery (SFA) are rare entities. Fewer than 50 cases have been reported in PubMed and the largest series consists of 13 patients. Here we report the case of a patient with bilateral true aneurysms in the SFA and the surgical treatment that was performed to treat them. Case report. A 78-yearold male with a history of chronic obstructive pulmonary disease, benign hypoplasia of the prostate and blindness since infancy due to pigmentary retinitis. The patient visited the emergency department after having lumps on the inner side of both thighs for several years and claudication of the soleus-gastrocnemius muscle in the left lower limb at 300 m. Examination revealed the presence of pulsatile masses with systolic murmurs in the mid-third of the thigh in both lower limbs (LL) and a distal to popliteal occlusion in the left lower limb. Doppler ultrasound recording was performed on the LL and the results showed aneurysmal dilatation measuring 72 × 35 mm in the right SFA and 63 × 28 mm in the left SFA. The angiography study of the LL confirmed the presence of aneurysms at that level. Elective surgery was performed involving resection of the aneurysm and end-to-end placement of an 8-mm PTFE graft. The aneurysms presented a thrombus and arteriosclerotic thickening of their walls. Anti-aggregating treatment consisting in 150 mg of acetylsalicylic acid was established and the patient was discharged from hospital five days after surgery. Conclusions. True aneurysms of the SFA are rare. They are associated with a high rate of thromboembolic complications and rupture. Preferred treatment consists in resection and placement of a prosthetic or venous graft. [ANGIOLOGIA 2008; 60: 149-54]