Ruptured superficial femoral artery aneurysm treated by simple ligation

A 79-year-old man, with a background of peripheral vascular disease, presented to the emergency department with a sudden increase in the size of his swelling in the right thigh, indicating rupture of his right superficial femoral artery aneurysm. His past medical history included having had a left femoropopliteal bypass (1986), abdominal aortic aneurysm repair (1991), repair of false aneurysm on the right (1992) and repair of left common femoral artery aneurysm (1995). On surgical exploration, four contiguous aneurysms in the right superficial femoral artery were identified, which measured around 25 cm in total length. After achieving control of the aneurysm, it was noted that the popliteal artery was unsuitable for anastomosis. However, the leg was still adequately perfused via collaterals in spite of the ligation, so nothing further was done. The patient was put on a heparin infusion postoperation, and had an uneventful recovery with a viable limb on discharge. It is a useful reminder that ligation can still be an option in vascular emergencies in some situations.