ORIGINAL ARTICLES   

Giornale Italiano di Chirurgia Vascolare 1998 September;5(3):159-68

Copyright © 2000 EDIZIONI MINERVA MEDICA

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.