Ruptured femoropopliteal artery aneurysms in von Recklinghausen neurofibromatosis

A 38-year-old woman with neurofibromatosis type 1 was referred for massive swelling of the left thigh, pain, and anemia. Angiography demonstrated three saccular aneurysms of the femoropopliteal artery. The largest measured 3 cm in diameter. Resection of the aneurysms and femoropopliteal interposition grafting using reversed saphenous vein was performed through a medial surgical approach. Arterial involvement in neurofibromatosis is a well known but infrequent occurrence. Stenotic lesions predominate. Aneurysmal defects are less common, and rupture of peripheral arteries is exceptional. Neurofibromatous invasion and dysplasia of the tunica media of the femoropopliteal vessel were confirmed by means of pathologic study. We think this is the second reported case of a femoropopliteal artery aneurysm and rupture associated with neurofibromatosis.