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Peripheral arterial aneurysms: causes, symptoms, diagnosis, treatment
Last reviewed: 05.07.2025
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Peripheral arterial aneurysms are pathological dilations of peripheral arteries caused by weakening of the arterial wall.
Approximately 70% of peripheral arterial aneurysms are popliteal; 20% are iliofemoral. Aneurysms in these locations are often associated with abdominal aortic aneurysms and are bilateral in more than 50% of cases. Rupture is relatively rare, but these aneurysms can lead to thromboembolism. They are much more common in men than in women (the ratio is more than 20:1); the average age at presentation is 65 years. Aneurysms in the arteries of the arms are relatively rare. They can cause limb ischemia, distal embolism, and stroke.
[ Causes of peripheral artery aneurysms
Infectious (mycotic) aneurysms can occur in any artery, but the femoral artery is most commonly affected. They are usually caused by infections with salmonella, staphylococcus, or treponema pallidum (the causative agent of syphilis).
Common causes include atherosclerosis, popliteal artery entrapment, and infected emboli.
Symptoms of peripheral artery aneurysms
Peripheral arterial aneurysms are usually asymptomatic. However, tenderness to palpation, coldness and pallor of the extremities, paresthesia, or pulselessness may develop due to thromboembolism or (rarely) rupture of the aneurysm. Infectious aneurysms may cause local pain, fever, malaise, and weight loss.
Treatment of peripheral arterial aneurysms
The risk of rupture of limb aneurysms is low (< 5% for popliteal and 1% for iliofemoral aneurysms). Surgical treatment is most often chosen for leg artery aneurysms. It is resorted to when the arteries are 2 times larger than normal or clinical symptoms appear. However, surgical treatment is prescribed for all arm artery aneurysms because the risk of serious complications (eg, thromboembolism) is high. The damaged arterial segment is excised and replaced with a graft. The limb can be saved after surgical repair in 90-98% of asymptomatic aneurysms and in 70-80% of clinically manifested aneurysms.