Femoral Artery Aneurysm

What is a femoral artery aneurysm?

A femoral artery aneurysm is a part of an artery in your thigh that stretches out or bulges to about twice its normal size. When this happens, all the layers of your artery wall stretch out too much. This weakens the artery wall, making it likely to tear. If it tears, you can lose a lot of blood from this major artery.

Femoral artery aneurysm types

Healthcare providers refer to femoral artery aneurysms by their location. The two types are:

• Type I femoral aneurysm: Your aneurysm stops before the part of your common femoral artery that splits or branches off into two smaller arteries (profunda and superficial femoral).
• Type II femoral aneurysm: Your aneurysm includes the branching point and your profunda artery.
• Type III femoral aneurysm: Your aneurysm involves only the superficial femoral artery (one of the branches of the common femoral artery).
• Type IV femoral aneurysm: Your aneurysm includes only the deep or profunda femoral artery.

Who does a femoral artery aneurysm affect?

People who get femoral aneurysms are most often men and people assigned male at birth (AMAB). Also, they’re usually older than age 70. You’re more likely to get a femoral artery aneurysm if you have these risk factors:

• High blood pressure.
• High cholesterol.
• A connective tissue disease.
• Tobacco product use.
• Atherosclerosis, such as a prior heart attack or peripheral artery disease.
• Someone in your family had an aneurysm.

How common is a femoral artery aneurysm?

Femoral artery aneurysms are rare, but you can have them in both of your legs. Some people have an aneurysm in their femoral artery and another artery at the same time. Aneurysms in blood vessels in your legs affect .007% of men and people assigned male at birth. The percentage is even lower for women and people assigned female at birth (AFAB).

How does a femoral artery aneurysm affect my body?

If you have a femoral artery aneurysm, it’s possible to have a blood clot that stays in your artery or travels to a different blood vessel. Also, an aneurysm can break open and cause a lot of bleeding (rupture).

What does a femoral artery aneurysm feel like?

Femoral artery aneurysm symptoms may include:

• A lump in your groin that may be pulsating.
• Swelling in your lower leg.
• Pressure or pain in your groin or leg.
• Blood clots.
• Rupture of the aneurysm (not common).

However, up to 40% of people with a femoral aneurysm don’t have any symptoms.

What causes a femoral artery aneurysm?

Femoral artery aneurysm causes may include:

• Atherosclerosis (most common cause).
• High blood pressure.
• Trauma from an accident or injury.
• Diseases that affect connective tissue, such as Ehlers-Danlos syndrome, Marfan syndrome or adventitial cystic disease.
• Behçet disease.

These causes can weaken your femoral artery wall and lead to an aneurysm.

How is a femoral artery aneurysm diagnosed?

Your healthcare provider may be able to feel a femoral artery aneurysm during a physical exam. However, the bulge in your groin can look and feel like a hernia. Tests can help them figure out what it is.

What tests will be done to diagnose a femoral artery aneurysm?

Tests to diagnose a femoral artery aneurysm and plan treatment for it include:

• An ultrasound.
• A CT (computed tomographic) angiogram.
• A magnetic resonance angiogram (MRA).

How do they fix an aneurysm in your leg?

Because the risk of a femoral artery aneurysm breaking open is low (1% to 14%), you may not need surgery. However, you may need surgery to repair your femoral artery aneurysm if:

• You have a blood clot or other symptoms.
• Your aneurysm bursts.
• Your aneurysm gets worse.
• Your aneurysm’s diameter is larger than 2.5 centimeters (about 1 inch).

To repair your femoral artery, a surgeon will do open surgery. That means they have to cut through your skin to see and work on the artery instead of making small incisions and using a camera to see inside. They cut out the aneurysm and replace it with a fabric graft.

You can think of it like a fire hose that got stretched in one section and is at risk of bursting from the water pressure. You’d need to patch that weak area to strengthen it so the water could keep flowing normally.

Complications of femoral artery aneurysm treatment

Surgery to repair a femoral aneurysm can lead to:

• Infection.
• Bleeding.
• Blood clots.

How long does it take to recover from this treatment?

You’ll need to spend three to 10 days in the hospital after your surgery. It may take a month or more to make a complete recovery.

How can I reduce my risk of a femoral artery aneurysm?

Since atherosclerosis is a major cause of femoral artery aneurysms, you can reduce your risk by managing your cholesterol and controlling your blood pressure. Exercising regularly and eating a low-fat diet may be all you need for this. However, many people need to take a cholesterol-lowering drug.

What can I expect if I have a femoral artery aneurysm?

A femoral artery aneurysm won’t go away without treatment. A healthcare provider can keep checking it to see if it’s getting larger and requires treatment.

Outlook for a femoral artery aneurysm

Aneurysm repairs usually have good results, with mortality rates of 1% to 5% around the time of surgery. Five years after surgery, about 85% of repaired blood vessels stay open. This means blood can flow through easily.

How do I take care of myself?

A healthcare provider will need to check your arteries regularly for the rest of your life. Regular checks help them find any new aneurysms before they’re large enough to be at risk of breaking open. Because smoking makes aneurysms grow, your provider will recommend stopping the use of tobacco products.

When should I go to the ER?

Get medical treatment right away if your leg or foot is:

• Weak.
• Swollen.
• Painful.
• Numb.
• Cold.
• Pale.

What questions should I ask my doctor?

Questions you may want to ask your provider include:

• Do you know the cause of my aneurysm?
• Do I need surgery for this aneurysm?
• Do I have more than one aneurysm?
• Can you recommend a diet to help lower my cholesterol?

Femoral artery aneurysm vs. pseudoaneurysm

Pseudoaneurysms (“false aneurysms”) are more common than femoral artery aneurysms. A pseudoaneurysm can happen after a procedure to diagnose or treat an issue with your artery. Unlike a true aneurysm, a pseudoaneurysm doesn’t affect all of your artery’s layers.

A note from Cleveland Clinic

Having an aneurysm in your femoral artery is very rare. However, if you have one, you can get a surgical repair before the aneurysm breaks or ruptures. Because this type of aneurysm isn’t common, it may give you peace of mind to find a provider who has a lot of experience with these surgeries.