Simultaneous Endovascular Abdominal Aortic Aneurysm Repair and Open Repair of Common Femoral Artery Aneurysm: Short Case Series and Current Review
Spyros Papadoulas, Melina Stathopoulou, Andreas Tsimpoukis, Chrysanthi P. Papageorgopoulou, Konstantinos G. Nikolakopoulos, Nikolaos Krinos, Aliki Skandali, Petros Zampakis, Petraq Mustaqe, Agron Dogjani, Francesk Mulita, Vasileios Leivaditis
Abstract
Background: Common femoral artery aneurysms are rare and are usually associated with aneurysms at other sites, mainly the aorta, iliac, popliteal, superficial femoral, and profunda femoral artery. This combination poses the challenge of synchronous repair for clinically relevant aneurysms. Although endovascular abdominal aortic aneurysm repair is the main type of treatment for abdominal aortic aneurysms nowadays, this is not true for common femoral aneurysms, where open repair remains the gold standard. These two distinct operations could be combined in a one-stage procedure when aortoiliac and common femoral aneurysms present simultaneously. This approach potentially saves time and costs, without increasing complications. Methods: A retrospective search was conducted in the Vascular Surgery Department database of a tertiary referral center for vascular surgery, covering procedures from January 2005 to May 2025. Patients were included if they had undergone simultaneous endovascular abdominal aortic aneurysm repair and open repair of a common femoral artery aneurysm. Clinical records, operative details, imaging studies, and follow-up data were reviewed. We additionally provide a literature review regarding this approach. This review additionally incorporates the current knowledge regarding the treatment of common femoral artery aneurysms. Results: Out of 668 endovascular abdominal aortic aneurysm repair procedures, three patients (0.45%) were identified. These three patients were among five patients who were treated for true common femoral artery aneurysm by open repair in the same time interval. All of the patients are currently in good condition without late complications. One patient, who had not performed any follow-up imaging, was diagnosed with large aneurysms at other sites, 10 years later. Conclusions: The combined one-stage endovascular abdominal aortic repair and open repair of a common femoral artery aneurysm by interposition grafting is technically a simple approach that led to satisfactory outcomes.