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Peripheral arterial aneurysms present characteristic locations. In the lower limbs, atherosclerotic aneurysms of the deep femoral artery are very rare. Authors report an interesting case of arteriosclerotic aneurysm of a branch of the profunda femoris artery observed in a 80 year-old man, and associated with an abdominal aortic aneurysm. Endo-aneurysmectomy was performed with a dacron patch interposition. Surgical treatment of this rate disease is discussed.

Experience of the management of 45 patients affected by popliteal artery aneurysms is reported. All patients, but one, underwent operative treatment. The importance of immediate surgical reconstruction whenever a popliteal artery aneurysm has been detected is stressed. In fact the most frequent complication represented by sudden thrombosis of the aneurysmatic sac and/or by peripheral embolization is generally followed by an irreversible closure of the vascular run off, determining the high rate of failures (28% in our experience) in spite of a prompt surgical reconstructive procedure.

From 1970 to October 1991, 26 patients affected by splanchnic artery aneurysms were observed and treated at the Department of General and Cardiovascular Surgery, University of Milan, Italy. Three splanchnic artery aneurysms were operated on in emergency. Visceral artery aneurysms are often completely silent and are generally detected during diagnostic procedures performed in order to clarify some diagnostic questions. When symptomatic they present a characteristic clinical picture of the involved vascular district. Two patients affected by aneurysmal disease of the proper hepatic artery died after operation. All the other splanchnic aneurysms underwent a successful surgical procedure. This study is aimed at analyzing some characteristic clinical pictures, diagnostic methods, therapeutic procedures and postoperative results.

The femoral region is the most common site of development of anastomotic pseudoaneurysms that represent a relatively frequent complication of reconstructive vascular surgery. Clinical examination alone generally is sufficient to diagnose these lesions because they usually appear as a pulsatile inguinal mass not accompanied by pain. Echography and angiodynography permit a better evaluation of size and blood flow. CT is useful to evaluate proximal aortic anastomosis specially in pseudoaneurysms with septic pathogenesis. Rupture or thrombosis are rare clinical presentations. Vascular reconstructive surgery is always suggested in this sort of pathology. In this paper the Authors report the clinical experience acquired from 1980 to 1990 in the General and Cardiovascular Surgery Department of the University of Milan (Head: Prof. Ugo Ruberti) is 34 cases of femoral anastomotic aseptic pseudoaneurysms, analyzing the pathogenesis of this sort of lesion, describing the surgical solutions adopted and reporting the immediate and late results.

The most frequent localisation of fibrous dysplasia of the arteries is at the renal arteries. Other localisations are rarer and those at the femoral as in the case described are exceptional. The case was observed in a 21-year-old woman who, in the absence of any previous traumatism and septic state, noticed the onset of a pulsating tumefaction at thigh level. Echography and arteriography showed the tumefaction to be an aneurysm of a collateral of the superficial femoral artery at the lower IIIrd of the thigh with the dimensions of a pigeon's egg. The aneurysm was successfully removed without the need for grafts and subsequent histological examination showed it was secondary to fibrous dysplasia. The rarity of such a clinical case is stressed.

Experience of the operative treatment of 45 popliteal aneurysms in 41 patients is reported. The importance of immediate surgical reconstruction whenever a popliteal artery aneurysm has been detected is stressed. In fact, the patency rate of the arterial substitutes which are utilised in the reconstructive technique, and therefore the fate of the affected limbs, is chiefly based on the presence of a sufficient run off. Ischaemic complication due to peripheral embolization or sudden thrombosis of the aneurysmatic sac is very often followed by the irreversible closure not only of the tibioperoneal arteries but also of most collateral vessels.