Sequential Endovascular Treatment of Bilateral Superficial Femoral Artery Aneurysms with Rupture Risk

Superficial femoral artery (SFA) aneurysms are uncommon, and bilateral involvement is rarely encountered. We report a case of bilateral SFA aneurysms with rupture risk that was treated using a staged endovascular strategy. A 77-year-old man presented with left groin pain and swelling, and imaging revealed bilateral SFA aneurysms, with the left lesion measuring 5 cm and containing extensive mural thrombus. Because the patient declined open surgery, urgent stent-graft exclusion of the left aneurysm was performed, followed by elective treatment of the contralateral side one week later. Both procedures were completed without complications, and follow-up imaging confirmed graft patency with complete aneurysm exclusion. This case supports sequential endovascular repair as a practical alternative in selected patients with bilateral SFA aneurysms.