Early Outcomes of Traumatic Femoral Artery Aneurysm (Open Repair versus Endovascular Treatment).

BACKGROUND: The goals of surgical treatment of traumatic femoral artery aneurysm (FAA) are to isolate and excise the aneurysm, prevent distal embolization, and allow effective revascularization. During recent years, endovascular surgery has become a valid alternative to open repair. We aimed to compare early outcomes of the stent graft in the treatment of traumatic FAA and open surgical procedures.

METHODS: This was a prospective study on 20 patients admitted to our hospital during the period from April 2016 to September 2017 with specific criteria of traumatic FAA. The patients were randomly divided into 2 groups with a one to one ratio between open repair (group I) and endovascular therapy (group II). We used the duplex scan in early follow-up 1 week and 1 month and 3 months postoperatively.

RESULTS: Twenty FAAs were treated as follows: Excision of the aneurysm in patients of group I and repair by primary sutures or bypass with no graft failure occurred intraoperatively. Ten stents were placed in ten FAAs in group II. An early patency rate of 100% in 1 week was found in both groups, and thrombosis in 1 stent graft occurred after 1 month and 3 months (95%). The mean time of surgical operations was 107.5 min, and the mean time of endovascular procedures was 85 min. The group I had a significantly longer mean hospital stay time (8 days) than group II (4.25 days); P value < 0.05.

CONCLUSIONS: FAA treatment can be performed easily and safely by surgery or endovascular procedures. Although the endovascular approach has several advantages, the incidence of thrombosis and high cost of stent grafts should be considered.