Popliteal artery aneurysms: A 25-year surgical experience

Abstract

Operative repair was undertaken for 51 popliteal aneurysms in 39 patients between 1958 and 1990. Operation was performed on an emergency basis in 19 extremities with limb-threatening ischemia and as an elective procedure in 32 extremities. Cumulative limb salvage (94%) rates and patency rates (67%) became significantly different at 6 years (p less than 0.05). Graft patency was affected by clinical presentation and runoff. After 1 year, cumulative patency for extremities with limb-threatening ischemia was significantly lower than for those having an elective operation (69% vs 100%, p less than 0.05). Runoff did not influence graft patency until 3 years, at which time cumulative patency was better in extremities with good runoff than in extremities with poor runoff (89% vs 30%, p less than 0.05). Limb salvage was affected only by presentation. All limb loss (three patients) occurred within the first month in extremities with graft occlusion after operation for limb-threatening ischemia. Runoff did not influence patency rates for extremities with limb-threatening ischemia, since no difference was observed in runoff between the two groups. We conclude that elective repair is indicated in all patients with popliteal aneurysms. It is associated with little risk to the patient, and prevents the need for operation in the setting of limb-threatening ischemia with its poorer overall results and definite incidence of amputation.

Colour Doppler sonography of limb arteries

“…Unlike those involving the abdominal aorta, popliteal aneurysms are prone to thrombose and to lead to episodes of peripheral embolization (up to 69 % of the cases) (Fig. 19) [81,82,83]. Embolic events can arise massively and cause acute limb ischaemia or can occur chronically leading to progressive impairment of runoff.…”

Long-term follow-up of surgically excluded popliteal artery aneurysms with multi-slice CT angiography and Doppler ultrasound

“…Nevertheless, some authors reported some cases of rupture of a previously ligated PAA [8,17]. This was uncommon, and it could be explained by the fact that patients died before the onset of the complication.…”

“…However, some cases of symptomatic enlargement and rupture of already excluded aneurysms have been reported [8,17]. The origin of this recurrence is not fully understood.…”

Recanalization of an Occluded Popliteal Artery Following Posterior Knee Dislocation

“…Elective popliteal aneurysm repair has 10-year patency rates between 66 and 92% and 10-year limb salvage rates from 93 to 100%. [12][13][14] When performed for limb-threatening ischemia, these grafts have 10-year patency rates of 39 to 60% and 10-year limb salvage rates between 79 and 84%. [12][13][14] While exclusion of the popliteal artery is clearly mandated when treating popliteal artery aneurysms, the same may not be true for popliteal arterial injury secondary to posterior knee dislocation.…”