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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY

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Official Journal of the Italian Society of Vascular and Endovascular Surgery
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Giornale Italiano di Chirurgia Vascolare 1998 September;5(3):159-68

language: English, Italian

Ruptured pop­li­teal ­artery aneu­rysms

De Troia A., Shahdeh P. M., Curci R., Cugnasca M., Odero A.

From the Department of Vascular Surgery University of Pavia, Italy IRCCS Policlinico “San Matteo”, Pavia, Italy


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Aim. The rup­ture of pop­li­teal ­artery aneu­rysms is a ­rare but ­very insid­i­ous com­pli­ca­tion. A ­review of the lit­er­a­ture for the ­past 40 ­years ­shows ­that the inci­dence of pop­li­teal aneu­rysm rup­ture is 2.6% (­range 0-16%) and the ­mean ampu­ta­tion ­rate is 20% (­range 0-100%). The aim of ­this ­study was to eval­u­ate the inci­dence of rup­ture, its clin­i­cal ­signs and spe­cif­ic ­aspects regard­ing the man­age­ment of ­this ­rare com­pli­ca­tion.
Methods. A ret­ro­spec­tive anal­y­sis of 42 pop­li­teal aneu­rysms was ­made in 38 ­patients, of ­whom 37 (97%) ­were ­male and 1 (3%) ­female, oper­at­ed at the Department of Vascular Surgery of the University of Pavia, IRCCS Policlinico San Matteo, dur­ing the peri­od ­from 1991 to 1997. Of the 42 pop­li­teal aneu­rysms stud­ied, 24 (57%) ­were symp­to­mat­ic (throm­bo­sis, embol­isa­tion) and 4 (9.5%) ­were rup­tured. Colour Doppler ultra­so­nog­ra­phy was per­formed in all cas­es and ­direct revas­cu­lar­isa­tion was ­achieved ­using syn­thet­ic ­graft mate­ri­al (Dacron and ­PTFE).
Results. It was not nec­es­sary to ­resort to ampu­ta­tion in any cas­es. Patency was ­achieved at 30 ­days in all cas­es, where­as in one ­patient the post­op­er­a­tive peri­od was com­pli­cat­ed by throm­bo­sis of the pop­li­teal ­vein.
Conclusions. Prompt and ear­ly inter­ven­tion ­remains the ­main rem­e­dy for treat­ment of rup­tured pop­li­teal aneu­rysms. A ­more exten­sive use of Doppler ultra­so­nog­ra­phy ­would ­enable a rap­id dif­fe­ren­tial diag­no­sis to be ­made ­with ­venous or ortho­pe­dic pathol­o­gies and ­would ­allow the inci­dence of ­this ­severe com­pli­ca­tion to be ­reduced.

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