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A vessel is considered to be aneurysmal when it enlarges to about one and a half to two times the size of the normal vessel. True femoral artery aneurysms are rare and include dilation of all the layers of the vessel wall. In contrast, femoral artery pseudoaneurysms are more commonly encountered in clinical practice, often after iatrogenic trauma from diagnostic or interventional arterial procedures. This activity describes the causes of femoral artery aneurysms, reviews the indications and contraindications for surgical repair, and highlights the role of the interprofessional team in the management of patients undergoing femoral artery aneurysms repair. Objectives: Identify the causes of femoral artery aneurysms. Describe the surgical technique involved in performing a femoral artery aneurysm repair. Summarize the complications of surgical repair of femoral artery aneurysms. Review interprofessional team strategies for enhancing care coordination and communication to advance the treatment of femoral artery aneurysms and improve patient outcomes. Access free multiple choice questions on this topic.

A vessel is considered to be aneurysmal when it enlarges to about one and a half to two times the size of the normal vessel. True femoral artery aneurysms are rare and include dilation of all the layers of the vessel wall. In contrast, femoral artery pseudoaneurysms are more commonly encountered in clinical practice, often after iatrogenic trauma from diagnostic or interventional arterial procedures. Pseudoaneurysms, also known as false aneurysms, do not involve all layers of the vessel wall. Patients with aortic or other peripheral aneurysms can have synchronous or metachronous femoral artery aneurysms. As with any peripheral or a visceral aneurysm, the main risks associated with femoral artery aneurysms include thrombosis/occlusion, distal embolization, and rupture. This clinical entity is rare; therefore, the natural history is not well defined.[1][2][3] Femoral artery aneurysms are more commonly seen in individuals who are older than 70 years of age and male. Femoral artery aneurysms can be bilateral in up to 70% of cases. Up to 25% of patients with femoral artery aneurysms can have an abdominal aortic or iliac artery aneurysm. Risk factors for femoral artery aneurysms include smoking, arteriosclerosis, high blood pressure, and systemic connective tissue disorders. In asymptomatic patients, these aneurysms may be detected by patients or on physical examination as a groin bulge or mass. Because of this presentation, it can be easily confused with a hernia. However, on physical examination, strong pulsation of this mass should raise the suspicion for a femoral artery aneurysm. A complete lower extremity vascular examination should be performed to ensure that there is no sign of distal embolization. In addition, the extremity should be inspected for swelling as large aneurysms can compress venous return from the lower extremity and cause lower extremity venous congestion/edema or even deep venous thrombosis. Patients may experience pain from pressure on surrounding structures or nerves. Patients should be asked about a preceding history of trauma to the groin. Physical examination should include a search for aneurysms at other body sites. As any arterial aneurysm can be mycotic, patients should be asked about symptoms of systemic infection and examined for signs of systemic infection (such as endocarditis).

In asymptomatic patients, these aneurysms may be detected by patients or on physical examination as a groin bulge or mass. Because of this presentation, it can be easily confused with a hernia. However, on physical examination, strong pulsation of this mass should raise the suspicion for a femoral artery aneurysm. A complete lower extremity vascular examination should be performed to ensure that there is no sign of distal embolization. In addition, the extremity should be inspected for swelling as large aneurysms can compress venous return from the lower extremity and cause lower extremity venous congestion/edema or even deep venous thrombosis. Patients may experience pain from pressure on surrounding structures or nerves. Patients should be asked about a preceding history of trauma to the groin. Physical examination should include a search for aneurysms at other body sites. As any arterial aneurysm can be mycotic, patients should be asked about symptoms of systemic infection and examined for signs of systemic infection (such as endocarditis). Work up for a femoral artery aneurysm can include an ultrasound, computed tomography angiography, or magnetic resonance angiography. Depending on the acuity of the situation, CT angiography is often the first investigation employed as it provides excellent anatomic information for possible intervention.[4][5][6]

The management of a femoral artery aneurysm is by an interprofessional team that includes an interventional cardiologist, radiologist, or a vascular surgeon. Today, minimally invasive procedures are used to close pseudoaneurysms of the femoral artery. but if the patient has atherosclerotic disease, then an open procedure with patch repair may be useful. It is important to communicate with the team on the type of closure planned. Recurrences are rare but may include loss of pulses, hematoma, and infection.

Knowledgable operative nurses are essential for this procedure. Perianasthesia and critical nurses monitor patients, administer medications, and communicate with the interprofessional team with issues and updates.