Coil embolization as an alternative endovascular approach for ruptured superficial femoral artery aneurysms

Purpose: True aneurysms of the superficial femoral artery (SFAA) are rare and, the endovascular approach using covered stents has gained more popularity. We report an endovascular alternative using embolization coils for treatment of a ruptured SFAA. Case description: An 88-old male admitted for a ruptured true SFAA (67×52mm in diameter and 70mm in length) presenting with painful mass pulsating in the proximal third of the left thigh. His surgical history consisted of an infrarenal abdominal aneurysm treated by open surgery and an ipsilateral popliteal aneurysm treated with prosthetic bypass by a medial approach; this was revealed to be occluded at the CT scan evaluation. The patient was asymptomatic for limb ischaemia, therefore we decided to perform embolization of the SFA with coils (MReye®Embolization Coil, Cook Medical, Bloomington,USA). Under local anaesthesia, via a 5-Fr sheath and an antegrade approach, coils were deployed first at the distal neck of the SFAA and then to its proximal neck. On the angiogram, complete aneurysm sac thrombosis with no leaks was achieved. At 6-month follow-up, the SFAA remained occluded, and the patient had not developed any sign of limb ischaemia. Conclusion: Coil embolization of SFAA in selected cases represents a feasible and safe endovascular alternative.