Deep femoral artery aneurysms (DFAA) are rare and their diagnosis is difficult in the early stage. We report a case of DFAA with rapid enlargement for three months. A 72-year-old man with chronic renal failure was admitted with a complaint of pain in the left medial thigh swollen. Computed tomography confirmed a left DFAA with diameter of 63 mm. Because magnetic resonance imaging (MRI) shows patency from superficial femoral artery to peripheral crural artery, we performed only resection of the aneurysm without re-vascularization of the distal deep femoral artery. MRI is useful to decide therapeutic strategy of DFAA.

A patient with critical limb ischemia and severe congestive heart failure who presented with right iliac stenoses and occlusion of the common femoral artery(CFA), deep femoral artery(DFA), superficial femoral artery, popliteal artery and crural arteries is presented. Iliac stenting and ilio-lateral femoral circumflex artery(LFCA) bypass with a reversed saphenous vein graft were successfully performed under regional anesthesia. In a case with CFA and DFA occlusion and well developed LFCA as a collateral circulation, a bypass to the descending branch of LFCA may be considered for limb salvage surgery.