Femoral false aneurysms: a recommendation for the method of repair

False aneurysm formation is a major complication of vascular surgery. The most frequent site of anastomotic false aneurysm formation is the femoral artery. Between January 1974 and June 1986, 26 patients with 42 femoral false aneurysms were treated at the Princess Alexandra Hospital. Aneurysms developed following Dacron arterial grafting (29 aneurysms), saphenous vein grafting (10 aneurysms), umbilical vein grafting (one aneurysm) and femoral embolectomy (two aneurysms). Arterial wall failure (with intact suture and graft) was the most frequent operative finding. Ten recurrent aneurysms developed. There was a significantly greater number of recurrences when resuture or patch repair was employed than when an interposition graft was used as a repair. The development of a femoral anastomotic false aneurysm should be viewed as a total failure of that anastomosis and repair should be by replacement with an interposition graft rather than repair of the failed anastomosis by suture or patch.