A rare para-anastomotic femoral artery aneurysm in a patient with history of femoro-popliteal bypass graft occlusion

INTRODUCTION: Para-anastomotic aneurysms may develop as a late complication of arterial reconstructions. They are mostly seen after abdominal aortic procedures and also are mostly encountered as pseudoaneurysms. PRESENTATION OF CASE: We report a true para-anastomotic aneurysm in the common femoral artery of a 57 year old man with an occluded femoro-popliteal bypass graft. We discuss the surgical management and possible causation of this extremely rare condition DISCUSSION: Para-anastomotic aneurysms can have some life-threatening consequences, such as erosion of adjacent tissues, distal embolization from mural thrombus and rupture of the aneurysmal sac. CONCLUSION: Endovascular treatment using stent grafts is highly effective, but it has some handicaps such as occlusion of major arterial orifices. For this reason, surgical reconstruction is the preferable choice for the management of para-anastomotic aneurysms.