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A Journal on Surgery

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Chirurgia 2004 December;17(6):199-202


language: Italian

Ruptured popliteal artery aneurysms: our experience

Siani A., Irace L., Laurito A., Stumpo R., Fazzini S., Faccenna F., Gattuso R., Intrieri F., Benedetti-Valentini F.


Aim. The rupture of a popliteal aneurysm is a rare but dangerous complication with an incidence of 2.6%. The aim of this study is to evaluate the clinical onset, diagnosis and best management of this complication.
Methods. From 1990 to 2001 63 popliteal aneurysms in 56 patients were operated in our departement. Of the 63 popliteal aneurysms treated, 21 were asymptomatic (33%) and 25 (28%) symptomatic, 12 (13%) showed an ischemic picture, 4 (4%) a swollen leg due to venous compression, and in 5 (5.6%) cases a ruptured aneurysm was present. Of the 5 patients, 4 were male and 1 was female. Color duplex scanning and CT scan were performed in all cases and a femoropopliteal revascularization below knee in 4 cases and above knee in 1 case was performed by medial approach. Reversed autologous saphenous vein was used in 2 cases and in 3 cases a 7 mm radially supported Gore prosthesis.
Results. No primary or secondary amputations occurred. One patient was lost at follow up, 4 patients showed a good outcome.
Conclusion. An early diagnosis and management remain the main treatment of ruptured popliteal aneurysms. An extensive use of color-duplex-scanning and CT scan seem suitable for the differential diagnosis with venous or orthopedic pathologies and for planning the revascularizzation. A medial approach is recomended for the control of proximal and distal vessels and treatment of the aneurysm sac is suggested to avoid venous impairement and bypass compression.

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