Introduction Ultrasound evaluation and angiography revealed a 6 cm SFAA. In the theatre a ruptured aneurysm of the Superficial femoral artery aneurysms (SFAAs) are distal superficial femoral artery (SFA) was confirmed. Total resection of the SFAA was performed and a 10rare. Atherosclerotic SFAAs usually remain undetected until rupture takes place, in contrast with cm-long 6-mm polytetrafluoroethylene (PTFE) graft was interposed. Ligation of the popliteal vein was also aneurysms of the common femoral and popliteal artery whose rupture is distinctly uncommon. Infected necessary. He was discharged 5 days later in good condition. SFAAs have a high tendency to rupture. The physician must be aware of their development in patients with bacteraemia, keeping in mind that their clinical presentation may sometimes be obscure. During the period 1990 to February 1999, 153 Case 2 patients were operated on for aneurysmal disease in our institution, including two patients with SFAA, A 66-year-old male was admitted with a suspected giving an incidence of 1.5%. The first patient presented deep venous thrombosis. Thirty days before admission with rupture of an atherosclerotic aneurysm and the he had a urinary tract infection, due to Escherichia coli. second one with simultaneous rupture of bilateral Twenty days later he developed pain and swelling in SFAAs. We report our experience in the management both lower limbs with persistent fever, despite the of SFAAs and the use of prosthetic grafts in infected antibiotic therapy. aneurysms, where the traditional practice demands On physical examination, the patient was pale and avoidance of such a material. A review of the literature had a low-grade fever. Tender, erythematous, pulsatile regarding SFAAs is also presented. masses were detected on the anteromedial aspect of both lower thighs. The calves were normal, distal pulses were present and the rest of the physical exCase 1 amination was unremarkable. Ultrasound evaluation revealed bilateral SFAAs with a small area of periAn 81-year-old male with a known abdominal aortic aneurysmal leakage. Deep venous thrombosis was not aneurysm was admitted with a pulsatile haematoma present. Laboratory tests revealed a white blood cell in his left thigh that had progressively expanded durcount of 17 800/mm and a haemoglobin concentration ing the previous 4 days. He was haemodynamically of 7.5 g/dl. A few hours after admission the rightstable. On physical examination a pulsatile haematoma sided aneurysm ruptured, causing an expanding with visible bruising was present in the posterior and haematoma in the posterior thigh. Emergency exmedial aspect of his left thigh up to the buttock. ploration through a medial approach confirmed the presence of a 6-cm ruptured aneurysm in the lower segment of SFA. The aneurysm had a wide neck ∗ Please address all correspondence to: J. A. Tsolakis, Department and a fusiform appearance. Following resection of the of Surgery, Medical School of University of Patras, 265 00 Patras, Greece. aneurysm, repair was performed using a 6-mm PTFE