Diagnosis and surgical treatment of femoral arterial aneurysms: a report of 81 cases HU Hai-di*, FENG Yong, CHANG Qing, et al. *Department of Surgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, China Corresponding author: HU Hai-di, E-mail: hu_haidi@hotmail.com Abstract Objective To summarize the experience in the management of femoral arterial aneurysm (FAA). Methods The clinical data of 81 patients with FAAs between January 1984 and August 2009 in the First Affiliated Hospital of China Medical University were retrospectively reviewed. Results There were 62 (76.5%) male and 19 (23.5%) female patients, aging from 16 to 75 years (mean 57±13 years). There were 82 FAAs, including 76 (92.7%) common femoral aneurysms, 4 (4.9%) superficial femoral aneurysms and 2 (2.4%) deep femoral aneurysms. The aneurysms were caused by trauma in 47 cases (58.0%), atherosclerosis in 28 cases (34.6%), infection in three (3.7%), Takayasu disease in one (1.2%), Behcet disease in one (1.2%) and unknown cause in one (1.2%). Six patients (7.4%) had multiple aneurysms, 5 patients (6.2%) had ruptured FAAs. All patients were managed successfully with aneurysmectomy and restoration of the extremity circulation. During the perioperative period, 3 patients occurred acute ischemia of the lower limbs, one received amputation and two recovered after therombectomy. Sixty-seven patients were followed from 2 months to 16 years (mean 5 years and 3 months), one patient with Takayasu disease died one year after operation, due to massive hemorrhage from a ruptured anastomotic aneurysm; 6 patients died more than 5 years after operation, due to cardiac diseases or carcinomas; 2 patients with atherosclerotic obliteran had chronic ischemia of the legs. The other surviving patients recovered well with no new vascular events and the reconstructed arteries were patent, with the long-term patency rate of 85.9% at 5 years. Conclusion Timely diagnosis, early surgical treatment by an aneurysmectomy with arterial reconstruction, can guarantee a good prognosis for FAAs. Long-term follow-up is needed to survey a new aneurysm formation.