A case of impending rupture of multiple peripheral aneurysm could be successfully managed with prosthetic graft replacement. The case was a 76-year-old male complaining of a pulsatile tumor in the right inguinal region with pain. Another pulsatile tumors were found in the left inguinal region and right popliteal fossa, namely the patient was suffered from multiple aneurysm. The right femoral aneurysm accompanied by remarkable tenderness was diagnosed as impending rupture. Pulsation was palpable in the peripheral arteries of both lower extremities. In surgery two-step approach was employed. At the first step, the both femoral aneurysms were excised, and prosthetic graft replacement was performed using 8 mm E-PTFE graft. The blood flow in the right femoral deep artery could not be preserved, because the deep artery associated with the aneurysm. Three weeks later, the right popliteal aneurysm was replaced with 8 mm E-PTFE graft. Histopathologically the aneurysms were arteriosclerotic.
Multiple peripheral aneurysm increasingly occurs and has a poor prognosis resulting from arterial embolism due to intratumal thrombi or rupture of an aneurysm. Aggressive operation is recommended as soon as it can be diagnosed.