Endovascular Repair of Ruptured Popliteal Artery Aneurysms: A Case Report and Review of the Literature

Abstract

Objective/BackgroundThe objectives were to report the management and outcomes of a 96-year-old man who presented with an acutely swollen right leg due to a ruptured popliteal aneurysm, and to review the relevant literature.MethodsA ruptured popliteal artery aneurysm is a rare diagnosis and is one that is often missed at time of presentation. Previous case reports have documented successful outcomes following surgical repair, and a smaller number following endovascular repair. This is a case report of a 96-year-old man who eventually underwent endovascular repair of a ruptured popliteal artery aneurysm after a delay in diagnosis. A literature review was performed to analyse published data in this field.ResultsThe patient underwent an uncomplicated endovascular repair with a GORE® VIABAHN® stent. A 15-week follow-up ultrasound demonstrated biphasic flow in a patent stent-graft with an unchanged aneurysm sac size and no evidence of an endoleak. A review of the literature demonstrated nine cases of ruptured non-mycotic popliteal artery aneurysms treated endovascularly. Seven cases survived the postoperative period, three had no follow-up recorded, and four cases had patent stent-grafts at time of follow-up.ConclusionSafe and effective endovascular repair of a ruptured popliteal artery aneurysm with endograft patency seen at the 15-week follow-up is reported. Review of the literature suggests that open repair remains the first-line management choice; however, endovascular repair is a valuable alternative. There is a further need for longer-term monitoring of endograft patency following endovascular repair.

Successful Endovascular Repair of a Ruptured Popliteal Artery Aneurysm: A Case Report and Literature Review

“…Endovascular repair is also advocated in another case study in a patient unfit for major surgical repair [4]. In this case report, endovascular stenting was performed in a 96year-old gentleman with a ruptured PAA.…”

“…A literature review conducted at the time of submission of this case report showed 62 [2][3][4][5][6][7][8][9][10][11][12][13] reported cases of ruptured PAA. Most cases reported were males, with an age range of 55-96 and a mean age of 81.…”

“…PAA rupture is a rare but recognized presentation that requires a rapid diagnosis and treatment for limb salvage [1]. The standard treatment for such ruptures is a surgical exclusion bypass; however, a number of other management options are described in the literature [2][3][4][5][6][7][8][9][10][11][12][13]. Such options include endovascular treatment with coil embolization [10] and/or stent graft.…”

Open repair of a symptomatic popliteal artery aneurysm in a 71-year-old patient: Case report

“…1 The incidence of rupture of PAA is estimated to be around 2%. 7 Up-to-date, the gold standard in the treatment of PAA has been surgical resection of the aneurysm and bypass grafting using either prosthesis graft or autologous vein. 10 It has been clearly established that aggressive approach…”

“…6 The incidence of rupture of PAA is estimated to be around 2%. 7 Up-to-date, open surgical resection remains a gold standard in the treatment of PAA with outstanding long-term results. Nevertheless, new endovascular techniques such as Viabahn stent graft or highly fl exible PTFE lined nitinol stents are becoming more sophisticated.…”