Peripheral Aneurysm

Most peripheral aneurysms occur in the popliteal artery, which runs down the back of your lower thigh and knee. Having a peripheral aneurysm in one leg increases the risk that you will also have one in your other leg. Less frequently, peripheral aneurysms can develop in the:

• femoral artery of your groin
• carotid artery in your neck
• arteries in your arms

Two out of three patients with a peripheral aneurysm do not notice any particular symptoms. Symptoms that are noticed may vary, depending on the location and size of your aneurysm, and may include:

• A pulsating lump that you can feel in your neck, arm or leg
• Leg or arm pain, or cramping, with exercise
• Leg or arm pain at rest
• Painful sores on toes or fingers
• Radiating pain or numbness in your arm or leg, caused by nerve compression
• Numbness or weakness on one side of your face or body
• Gangrene (dead tissue), which results from a severe blockage in the artery in a limb

Transient Ischemic Attack

If an aneurysm develops in the carotid artery, symptoms can include transient ischemic attack (TIA) or stroke. A TIA occurs when the blood supply to part of the brain is briefly interrupted.

TIA symptoms, which usually occur suddenly, are similar to those of stroke but only last for a few minutes up to 24 hours:

• Numbness or weakness in the face, arm, or leg, especially on one side of the body.
• Confusion or difficulty in talking or understanding speech
• Trouble seeing in one or both eyes
• Difficulty with walking, dizziness, or loss of balance and coordination

Risk Factors

• Smoking
• High blood pressure
• High cholesterol
• Obesity
• Family history of heart or vascular disease
• Age: Most people diagnosed with peripheral aneurysms are in their 60s and 70s
• Gender: Abdominal aortic aneurysms and aneurysms of the leg arteries occur more frequently in males.

A peripheral aneurysm also increases the chances of having an aortic aneurysm. Researchers believe that atherosclerosis (hardening of the arteries, which occurs as plaque builds up) is associated with many peripheral aneurysms, as is the case for many aortic aneurysms.

In most cases, peripheral aneurysms are detected by chance during a routine physical exam or on an imaging exam ordered for another reason. As part of a routine checkup, your physician may look for an aneurysm in your groin or thigh.

Tests to help confirm whether you have a peripheral aneurysm include:

• Ultrasound
• CT scan
• MRI
• Angiogram

Treatment of peripheral aneurysms depends on:

• Presence of symptoms
• Size and location or the aneurysm
• Whether blood flow has been compromised by:
  • Clotting of the aneurysm itself
  • Blood clots that have broken loose from the aneurysm and lodged in downstream arteries, blocking their blood flow

Especially in the case of a small aneurysm, peripheral aneurysms are sometimes managed without surgery; usually, you are checked once or twice a year to monitor the aneurysm for growth and development of symptoms.

Although nonsurgical management cannot “cure” an aneurysm, physicians will usually make recommendations to patients who have atherosclerosis, such as:

• Control your risk factors through diet and lifestyle changes, especially by quitting smoking
• Walk regularly to keep blood flowing in the legs
• Take care not to cross your legs or squat
• Clean your feet regularly and look for sores that don’t heal

Aneurysms in the back of the knee or thigh that are larger than one inch in diameter usually require open surgical bypass or surgical replacement.

Endovascular stent graft repairs are less invasive surgical options in which catheters are threaded into the blood vessels to guide a stent graft to the site of the aneurysm, which prevents the aneurysm from rupturing.