COMPLICATIONS AND TREATMENT OF POPLITEAL ANEURYSMS

  • 1 January 1978
    • journal article
    • research article
    • Vol. 84  (6) , 775-783
Abstract
Because complications are so often present with arteriosclerotic popliteal aneurysms, treatment results are less than optimal in contrast to aneurysms at other sites. From 1963-1977, 40 surgically treated aneurysms in 30 patients were studied. Seventeen limbs presented asymptomatic aneurysms (42.5%); 4 had pressure symptoms (10%); 1 had rupture and ischemia (2.5); 9 had acute thromboses and ischemia (22.5%); and 9 had chronic ischemia and claudication (22.5%). Seventeen aneurysms were thrombosed (42.5%). Diameters of all aneurysms measured at operation ranged from 1.0-10 cm. Generally, larger aneurysms were patent, and thromboses were common in the smaller aneurysms, with an average diameter of 2.5 cm. Saphenous vein grafts were used most frequently for interpolation grafts (65%) and bypass grafts (12.5%). Prostheses were used in 7.5%, endarterectomy and aneurysmorraphy in 5%. Popliteal reconstruction was accomplished initially in 40 limbs, with 2 early failures and 10 late failures with loss of 2 limbs. The cumulative patency rate for 40 limbs at risk at 5 and 10 yr was 75.9%; at 14 yr the patency rate was 62.6%. Early diagnosis is difficult due to physical limitations. Since thromboses precede popliteal aneurysms, early recognition and treatment are important to improve limb salvage rates.