An infected femoral aneurysm or pseudoaneurysm is not an uncommon situation. It often regards IVD users who have experienced multiples punctures on the femoral vessels. It is usually presented in males and is more often on the left femoral side. Treatment of these patients can consist an urgency or emergency condition. The treatment of aneurysm resection and arterial reconstruction with an in-situ interposition graft which is the way to go for an non-infected aneurysm cannot be the solution in these patients as there is always the risk of the post-operative graft infection (even if it is not synthetic) and subsequent anastomoses disruption and heavy bleeding.

Probably, the best way to deal with such cases is a relatively simpler solution. What is that? Just aneurysm ligation (proximally and distally) and as complete excision of the infected tissues as possible. Is there danger of limb ischemia and amputation? As long as the femoral bifurcation is preserved, it consists a significant collateral way around the ligated common femoral artery. The blood supply to the leg is from the internal iliac artery to the profunda femoris to the superficial femoral artery and the rest of the leg.

If a subsequent leg ischemia is developed, it can be dealt with a bypass from the common or external iliac artery to the above knee popliteal artery through the thyroid foramen.

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