Cor Vasa 2004, 45(6):260-263

A comprehensive approach to the treatment of popliteal artery aneurysms - the timing of run-off tract restoration and arterial surgical reconstruction

Jan Vojáček^1,*, Pavel Šebesta¹, Petr Czinner¹, Tomáš Klika¹, Petr Štádler¹, Petr Šedivý¹, Petr Křiváček¹, Vladimír Borůvka²

¹ Klinika cévní chirurgie

² Klinika radiologie, Nemocnice Na Homolce, Praha, Česká republika

Objectives:
The purpose of this study was to evaluate the results of surgical treatment of popliteal artery aneurysms (PAA).

Materials and methods:
We present a cohort of 80 patients with the diagnosis of PAA treated in our department in the years 1992 to 2000 with a mean follow-up period of 51 (1-108) months. The group included 76 men (95%) and 4 women (5%). The mean age was 64 years. In 49 patients (61%), PAA was present bilaterally whilst the remaining 31 (39%) had only unilateral lesions. Seventy-five patients (94%) were eligible for surgical treatment. Among those, a total of 87 PAA were operated. The remainder (6%) received conservative treatment. Primary PAA symptoms in our cohort were: thromboembolic complications in 39%, claudications in 26%, PAA rupture in 1%. An asymptomatic aneurysm was diagnosed in 34%.

Results:
There was only one early in-hospital occlusion of the reconstruction. The primary patency rate of the vein graft was 98%. When a prosthetic vascular graft (PTFE) was used, the primary and secondary late patency rates were 80% and 85%, respectively. Ten patients with thromboembolic PAA complications were treated successfully by local fibrinolysis. In all, aneurysmal exclusion and revascularization of the extremity were undertaken.

Conclusion:
In conclusion, the authors highlight the importance of immediate surgical treatment upon diagnosis of PAA to reduce the possibility of thromboembolic complications. If these do occur, run-off tract restoration using fibrinolysis is essential as well as subsequent surgical arterial reconstruction, preferably using an autologous vein graft.

Keywords: Popliteal artery aneurysm; Local fibrinolysis

Published: June 1, 2004  Show citation