Acute thrombotic occlusion of a profunda femoris artery aneurysm

A profunda femoris artery aneurysm (PFAA) is an extremely rare peripheral arterial lesion, often first detected following rupture or swelling of the groin or thigh region. We report a 74-year-old man who presented with acute thigh pain caused by thrombotic occlusion of a left PFAA associated with a common femoral artery aneurysm (CFAA). Contrast-enhanced computed tomography at presentation demonstrated complete left PFAA thrombosis and partial thrombus formation within the left superficial femoral artery. The aneurysms' diameters were 30 mm for the left CFAA and 35 mm for the left PFAA. The patient's symptoms stabilized after systemic heparinization. Considering the recurrent thrombosis and potential aneurysmal rupture risks, an elective surgical intervention was performed. This procedure consisted of PFAA ligation, prosthetic graft replacement of the CFAA, and lateral circumflex femoral artery branch reconstruction. The patient's postoperative course was uneventful, and follow-up imaging confirmed excellent graft patency and preserved thigh perfusion.