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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
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
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.