Background

Popliteal aneurysms (PAs) are the most frequent peripheral artery aneurysms, and those of more than 2 cm in diameter are considered candidates for elective surgery. Although the standard treatment of popliteal artery aneurysms has been open repair, there are increasing reports in the literature of endovascular management, which allows a quicker recovery and a shorter hospital stay. In this study, results after either open or endovascular treatments are assessed.

Methods

Between January 2004 and January 2009, 21 PAs were treated in 21 patients: short- and midterm outcomes have been retrospectively evaluated.

Methods

Between January 2004 and January 2009, 21 PAs were treated in 21 patients: short- and midterm outcomes have been retrospectively evaluated.

Results

Six patients (28.6%) presented bilateral PAs. Mean age was 73 years (range 46–95 years). One patient was female. Mean diameter of PAs was 3.7 cm (range 1.6–9.5 cm). Two (9.1%) aneurysms were asymptomatic. Seven (33.3%) patients presented claudicatio intermittens, and 13 (61.9%) patients had acute ischemia of lower limbs (ALI). Fifteen (68.2%) patients, 13 with ALI and 2 with severe claudicatio intermittens, underwent intraarterial thrombolytic therapy. Eleven (50%) patients were operated on, six (54.5%) through medial approach. In one patient, an ePTFE graft was implanted for an unsuitable saphenous vein. Nine (40.9%) patients underwent endovascular aneurysmal exclusion. Five patients presented an asymptomatic PA, contralateral to the treated one, with mean diameter of 1.32 cm (range 1.2–1.5 cm, S.D. 0.13). All these small and asymptomatic PAs were not treated. A 57-year-old patient presented ALI due to complete thrombosis of a PA with diameter of 1.6 cm, and he successfully underwent intraarterial thrombolytic therapy followed by oral anticoagulants, without any further treatment. The mean follow-up of endovascularly approached patients was 15 months. Three surgically treated patients, suffering ALI and an extremely poor distal runoff, underwent early amputation (30 days). In surgically treated patients, primary and secondary patency rates were, respectively, 62.5% (5/8 patients) and 87.5% (7/8 patients). After endovascular exclusion, primary and secondary patency rates were 60% (6/9+1, hybrid, patients) and 100%.

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