Patients with abdominal aortic aneurysm have a high prevalence of popliteal artery aneurysms

Abstract

Patients with abdominal aortic aneurysms (AAA) are more prone to develop popliteal artery aneurysms (PAA), but the prevalence is not well known. Our aim was to investigate the prevalence of PAA in patients with AAA, and to determine whether a certain risk factor profile is more commonly found in patients with concurrent aneurysms. All AAA patients (ICD code I71.3, I71.4) attending the outpatient clinic at the Karolinska University Hospital between 2011 and 2013 were included in the study cohort (n=465); 48% (225) had been subjected to an ultrasound or computed tomography scan of their popliteal arteries. In these patients, three definitions of PAA were considered (⩾ 10.5, ⩾ 12, ⩾ 15 mm), although the overall analysis is based on PAA ⩾ 12 mm. The mean age was 70.7 years (SD 7.5), 89% were men, and the mean AAA diameter was 47 mm (SD 14). The prevalence of PAA was 19% (n=43) by definition ⩾ 12 mm, and 11% (n=25) with 15 mm. Claudication was more frequently found in AAA patients with PAA than patients without PAA. Sensitivity between clinical examination and radiology was 26%, and the specificity for clinical examination was 90%. In conclusion, owing to the high prevalence of PAA in AAA patients, described by us and others, the low cost and risks associated with ultrasound and the poor sensitivity at clinical examination, all women and men with AAA should undergo one radiological examination of their popliteal arteries.

Popliteal Aneurysms are Common Among Men With Screening Detected Abdominal Aortic Aneurysms, and Prevalence Correlates With the Diameters of the Common Iliac Arteries

“…With the PA definition of !12 mm, in a retrospective study of patients diagnosed or treated for AAA, thus with much larger AAAs than in this study, the prevalence was 19%. 9 In this study, if only !12 mm was used as the definition, the prevalence would be 14% in the AA group. The combined definition of 12 mm diameter and/ or 1.5 times the adjacent vessel has been used.…”

“…There was no correlation with aortic diameter, but a positive correlation with CIA diameter. The definition of a popliteal aneurysm is controversial and a number of definitions have been suggested in different reports: 6,7,18,19 50% larger than a normal diameter, 9 15 or 19 mm in diameter, 6,7 50% larger than the adjacent vessel (i.e. the distal SFA) or 50% larger than the contralateral, non-aneurysmal artery.…”

“…7 There is a well known association between PA and AAA. Patients treated for PA have a concomitant AAA in 34%e40% of cases, 2,8 but the prevalence of PA among patients who were diagnosed with, or operated on, AAA 7,9 is less well studied. Normal vessel size is correlated with age, gender, and body size, but it is not well known how PA is correlated with aortic enlargement.…”

Therapie primärer Aneurysmen der Extremitätenarterien

“…Die Prävalenz von Poplitealaneurysmen (PAA) bei Patienten mit Aortenaneurysmen ist signifikant erhöht [42]. Tuveson et al beschreiben in einer aktuellen Arbeit eine Prävalenz für PAA von 19 % bei Patienten mit abdominellem Aortenaneurysma (AAA), wenn als Grenze für die Definition des PAA 12 mm angenommen werden [43]. Die Vascunet Collaboration berichtete kürzlich über durchschnittlich 9,6 PAA-Versorgungen/Mio.…”

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

“…3 However, Tuveson et al had shown that its prevalence seems to be even greater in patients with abdominal aortic aneurysm. 4 The defi ning size of classifying PA as a PAA differs among authors. Some authors defi ne PAA as a diameter of PA exceeding 0.7 cm, while others report threshold value of 2 cm, or 150% of the normal artery diameter.…”