A 61-year-old man with an aneurysm of the common and deep femoral arteries underwent successful vascular reconstruction. The patient presented with localized pain and a rapidly enlarging pulsatile mass in the femoral triangle. A graft was placed from the left common femoral artery to the left superficial and deep femoral arteries. No ischemic symptoms or thrombosis developed postoperatively. Successful reconstruction with a graft is rare in this situation, with less than 30 cases reported in Japan to date. This type of aneurysm is characterized by rapid enlargement and severe atherosclerotic changes. Ischemic complications may occur after surgical treatment of a ruptured deep femoral artery aneurysm. We recommend reconstruction using the saphenous vein or a vascular prosthesis, as there have been some reports of patients requiring leg amputation following ligation of the deep femoral artery.
A 62-year-old man was transported to the emergency medical center because of blunt chest trauma combined with multiple trauma after a car accident. He complained of severe back pain. Contrast-enhanced computed tomography revealed left hemopneumothorax with multiple left rib fractures, a scapular fracture, lung contusion, liver injury, right renal injury, and acute aortic dissection. Although open surgical repair and endovascular stent grafting were considered, primarily nonoperative management of the thoracic aortic injury under blood pressure control was selected because of the multiple trauma, type B aortic dissection, and oral administration of two antiplatelet drugs. The patient's hemodynamic and respiratory conditions remained stable in the intensive care unit, and the aortic dissection improved. We herein report a rare case of blunt thoracic aortic injury with oral administration of antiplatelet drugs resulting in multiple trauma and acute aortic dissection treated nonoperatively.