Spontaneous rupture of the superficial femoral artery treated via an endovascular approach.

Isolated spontaneous rupture of the superficial femoral artery is very uncommon. To our knowledge, only 5 other cases have been reported in the medical literature. Herein, we report the case of an 86-year-old woman who was admitted to our hospital with a 4-day history of progressive swelling of the left thigh. The presence of a pulsating mass with paresthesia of the lower limb and anemia suggested a hematoma of the thigh. A computed tomographic scan revealed a 4-cm-diameter pseudoaneurysm of the left superficial femoral artery and a large hematoma of the medial muscle compartment. A nitinol-polytetrafluoroethylene VIABAHN self-expanding stent-graft (5-mm diameterx50-mm length) was placed beyond the arterial lesion, and a fasciotomy of the thigh was performed. On the 10th postoperative day, the patient was discharged from the hospital in good condition. In cases of spontaneous swelling of the thigh in the absence of trauma or other apparent causes, spontaneous rupture of the superficial femoral artery should be suspected. Surgical treatment is preferable in young patients. In patients who are elderly or in poor condition, endovascular therapy is preferable when there is diffuse atherosclerosis of the artery.