Femoral Aneurysm

Overview

A femoral aneurysm is an abnormal bulge or ballooning in the wall of the femoral artery, the large blood vessel that carries blood down through the groin and into the leg. When part of the artery wall weakens, blood pressure can cause it to stretch outward and form an aneurysm.

Femoral aneurysms are often felt as a pulsing lump in the groin. They are less common than aneurysms in the abdomen but matter because they can enlarge, form blood clots that block circulation to the leg, or, less often, rupture. Many are linked to wider artery disease, so finding one is a reason to check other arteries as well.

Because femoral aneurysms frequently occur alongside aneurysms elsewhere, finding one prompts doctors to look at the abdominal aorta and the opposite leg as well. Catching aneurysms before they cause problems allows planned treatment rather than emergency surgery, which is why screening at-risk people is worthwhile.

Symptoms

Some femoral aneurysms cause no symptoms and are found during an exam or imaging. When symptoms occur, they may include:

• A pulsing or throbbing lump in the groin or upper thigh
• Pain or tenderness in the groin or leg
• Swelling in the leg
• Leg coldness, numbness, or color change if blood flow is reduced
• Pain when walking that eases with rest

Sudden severe pain, a rapidly enlarging or painful lump, a cold and pale leg, or signs of bleeding are emergencies. Call emergency services right away.

Because many femoral aneurysms cause few or no symptoms, they are sometimes found only when a doctor feels a pulsing lump during an examination or when imaging is done for another reason. Paying attention to a new lump in the groin or unexplained leg discomfort can help bring it to medical attention sooner.

Causes

Femoral aneurysms develop when the artery wall weakens. Common contributing factors include:

• Atherosclerosis: Hardening and narrowing of the arteries that weakens the wall.
• High blood pressure: Added stress on the artery wall over time.
• Smoking: A major risk factor for artery damage and aneurysms.
• Injury or medical procedures: Trauma or punctures of the artery, including after some catheter procedures (a pseudoaneurysm).
• Connective tissue or inflammatory conditions: Less commonly, diseases that weaken blood vessels.

Risk Factors

• Smoking
• High blood pressure
• Atherosclerosis or other artery disease
• Older age
• Male sex
• Aneurysms elsewhere, such as in the abdomen
• Previous groin artery procedures or injury

Diagnosis

Doctors diagnose a femoral aneurysm with examination and imaging:

• Physical examination: Feeling for a pulsing lump in the groin.
• Ultrasound: A common, noninvasive way to confirm and measure the aneurysm.
• CT or MRI angiography: Detailed imaging to assess the size, shape, and blood flow, and to plan treatment.

Because aneurysms often occur together, doctors may also check the abdominal aorta and other arteries.

The size of the aneurysm is an important part of the assessment, since larger aneurysms are more likely to cause problems and may be more likely to need repair rather than monitoring.

Treatment

Treatment depends on the aneurysm's size, symptoms, and risk.

• Monitoring: Small, symptom-free aneurysms may be watched with regular ultrasound, along with controlling blood pressure and stopping smoking.
• Surgical repair: Larger or symptomatic aneurysms are often repaired by removing or bypassing the weakened section with a graft.
• Treating clots or blockage: Restoring blood flow if a clot has reduced circulation to the leg.
• Emergency surgery: Needed if the aneurysm ruptures or threatens the limb.

Managing risk factors such as blood pressure, cholesterol, and smoking is important for long-term care.

After repair, regular follow-up with imaging is often recommended to check the graft and watch for new aneurysms. Continuing to control blood pressure and cholesterol and avoiding tobacco protects the repaired artery and the rest of the circulation over the long term.

Prevention

• Do not smoke, and seek help to quit if you do
• Keep blood pressure and cholesterol well controlled
• Stay physically active and maintain a healthy weight
• Manage diabetes and other conditions that harm arteries
• Attend follow-up imaging if you have a known aneurysm

When to See a Doctor

See a doctor if you notice a pulsing lump in the groin or thigh, or new leg pain or swelling. Call emergency services immediately for:

• Sudden, severe groin or leg pain
• A leg that becomes cold, pale, numb, or weak
• A rapidly growing or very painful lump
• Signs of bleeding or collapse

These can indicate a clot, blockage, or rupture that requires urgent treatment.

Related Topics

Frequently Asked Questions

References

1. Society for Vascular Surgery. Peripheral Aneurysms.
2. Mayo Clinic. Aneurysms.
3. MedlinePlus, U.S. National Library of Medicine. Aneurysm.
4. National Heart, Lung, and Blood Institute (NHLBI). Aneurysm.