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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
Italian Journal of Vascular and Endovascular Surgery 2015 December;22(4):197-201
Symptomatic popliteal artery aneurysms as limb threatening disease
Pasternak J. 1, Nikolić D. 1, Vučaj Ćirilović V. 2, Popović V. 1
1 Clinic of Vascular and Endovascular Surgery, Clinical Centre Vojvodina, Novi Sad, Serbia;
2 Department of Radiology, Clinical Centre Vojvodina, Novi Sad, Serbia
AIM: Amputation after symptomatic popliteal artery aneurysm repair was the primary endpoints in this study.
METHODS: Beside age, gender, risk factors for development of popliteal artery aneurysm (PAA) and concomitant aneurysms of other localizations, we have analyzed diameter of aneurysm, symptoms of PAA, incidence of amputation, complications, morbidity and mortality of observed patients. Following the proper diagnostic algorithm and morphological assessment of PAA endovascular treatment suitability, all patients underwent arterial flow restoration by either graft interposition or anatomic/ extraanatomic bypass, in general endotracheal or spinal anesthesia.
RESULTS: In 5-year period 57 patients had popliteal aneurysm open surgery. Postoperatively 12 patients underwent amputation of the lower extremity. Popliteal artery aneurysm was usually associated with contralateral popliteal artery aneurysm (21.05%), abdominal aorta aneurysm (19.29%), femoral aneurysm (10.52%), iliac and crural aneurysm (3.5%). Acute ischemia in the entire examined population was present in 40.35% cases, intermittent claudication in 22.81%, tissue loss in 19.29%, rest pain III in 8.77%, deep vein thrombosis in 7.01% and the rupture of the aneurysm in 1.75% of cases. The association of risk factors in patients without limb amputation showed that the high blood pressure is the leading risk factor in both groups.
CONCLUSION: Clinical symptom of acute ischemia is associated with high percentage of lower limb amputation. Early detection and elective surgical treatment of PAA allows obtaining desirable treatment results and limb salvage. PAA is often associated with contralateral PAA and abdominal aortic aneurysm. Therefore, screening of both popliteal arteries, as well as aortoiliac and infrainguinal arterial brnches is essential.