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Swelling in the left mid thigh (a) and signs of distal microembolization (b).
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The left lower limb was well-perfused, but there was ecchymosis and a pulsatile swelling between the mid and distal thirds of the thigh, in the anteromedial region ( Figure 1 a). Inspection of the left foot also revealed signs of distal microembolization ( Figure 1 b) and popliteal and distal pulses were absent. 
Ultrasonographic appearance of the femoral artery aneurysm.
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SFA measuring 5.8 x 5.3 cm and with associated mural thrombi and perivascular accumulations compatible with a ruptured aneurysm ( Figure 2 ). Since angiotomography was not available at the service providing care, the decision was taken to perform emergency surgical treatment. 
Intraoperative images showing the ruptured femoral artery aneurysm, dissected with proximal and distal repair (a, b); Interposition of the reversed great saphenous vein (c).
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Once this had been removed, the ruptured SFA aneurysm could be seen ( Figures 3 3b). Revascularization of the limb was then accomplished by interposition of the contralateral great saphenous vein in reverse, with end-to-side anastomosis - taking into consideration the diameter of the femoral artery and the significant destruction of its walls, as illustrated in Figure 3 c.