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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
Italian Journal of Vascular and Endovascular Surgery 2004 Dicembre;11(4):147-54
Femoral and popliteal aneurysms. Observations on 48 cases
Angelini R., Rutolo F., Cozzolino G., Spigonardo F.
Unit of Vascular Surgery SS Annunziata Hospital, Chieti, Italy
Aim. Aneurysms of the femoral popliteal artery represent 80% of peripheral aneurysms; more specifically, aneurysms of the popliteal area account for 70%. In 35-70% of the cases, this pathology shows bilateral lesions and is associated with the aneurysm of the abdominal aorta in a few cases.
Methods. The study is carried out on 30 patients affected by 48 aneurysms (33 popliteal and 15 femoral aneurysms) observed over the last 5 years. Sixteen patients (53.3%) affected by mono-bilateral femoral and/or popliteal aneurysmatic lesion had an aneurysm of the abdominal aorta, this has always been a priority for surgery; 25 patients, affected by 37 aneurysms, 31 of which were treated as follow: 28 were treated surgically and 3 underwent a stenting treament
Results. A thrombosis of popliteal PTEE graft resulting in an amputation on postoperative day 4 and 3 hematomas of the popliteal area were observed. Clinical follow-up was carried out every 6 months. The femoral area was 100% free from blockages, after 18 months, the popliteal area remained blockage free 95.23% after 1 month and this percentage decreased to 87.5% after 18 months.Moreover, 3 cases were successfully healed by means of stenting treatment. Three cases are referred to: in 1 case this type of treatment was planned and in the other 2 urgent surgery was performed.
Conclusion. As for popliteal aneurysms, the posterior approach used in 4 cases was part of the reason for no aneurysms encountered due to entrapment. If it was not possible to carry out a multilayer TC angiography, angiography and color Doppler were necessary in cases where an ischemia of the limb had occurred. In treating a popliteal aneurysm, its chances of remaining free from blockages after surgery depends on the run-off entity before operation. Acute thrombosis leads to the loss of collateral circulation compromising the success of surgery and causes post ischemic sequelae..
Due to its nature, the femoral aneurysm has a better prognosis and creates fewer problems from a technical and surgical point of view.