A True Aneurysm of Perforating Branch of the Deep Femoral Artery Treated by Surgery Using a Posterior Approach

Abstract

Deep femoral aneurysm has been reported to comprise 0.5% of all peripheral aneurysm cases and is considered to be a rare disease. We had a case involving an aneurysm of the perforating artery, which is a branch of the femoral artery. The patient was an 81-year-old woman presenting with a pulsatile mass and pain on the posterior aspect of her right thigh. We believed that surgical intervention to prevent major arterial rupture was indicated due to the presence of a large aneurysm measuring 50 mm in diameter and 110 mm in length. However, as reaching the aneurysm site via an anterior approach proved difficult, we used a posterior approach with the patient in a prone position. Due to the possibility that centrally securing the lesion or blocking blood flow could become unstable, a percutaneous transluminal angioplasty(PTA) balloon catheter was indwelled in the femoral artery in the deflated state immediately prior to surgery. We believe that this method may be a useful treatment option when blocking is impossible under direct view. Only the lesion present in the perforating artery was excised in the present case; postoperative symptoms disappeared, and no blood flow disturbances were observed.