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International Angiology 1998 March;17(1):28-33

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Outcome after early treatment of popliteal artery aneurysms

Taurino M., Calisti A., Grossi R., Maggiore C., Speziale F., Fiorani P.

From the First Chair of Vascular Surgery, Institute of Second Surgical Clinic, Policlinico Umberto I, University of Rome “La Sapienza”, Rome, Italy


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Background. Aneurysms of the pop­li­teal ­artery are rare ­events with an esti­mat­ed inci­dence of 0.1-2.8%. Their clin­i­cal impor­tance ­depends on their pro­pen­sity to cause throm­boem­bol­ic com­pli­ca­tions or to rup­ture (18 to 31% of cases). This study was ­designed to ­assess the advan­tag­es of elec­tive treat­ment of asymp­to­mat­ic pop­li­teal ­artery aneu­rysms so as to avoid the ­severe clin­i­cal man­i­fes­ta­tions that even­tu­al­ly arise if they ­remain untreat­ed.
Methods. From 1980 to 1995, in our department we treat­ed 28 pop­li­teal aneu­rysms in 23 ­patients (19 elec­tive oper­a­tions and 6 emer­gen­cies). Three of the aneu­rysms ­proved amen­able to fibrin­o­lyt­ic ther­a­py alone. Follow-up last­ed a mean 48 ­months (range 3 ­months to 15 years) in 20 ­patients (23 revas­cu­lar­iza­tions).
Results. Global paten­cy was 91.3%. Two throm­bosed bypass­es were treat­ed by throm­bol­y­sis; in one case it did not ­resolve the ischae­mia and the leg was ampu­tat­ed. In one case only, a graft ­became infect­ed but this respond­ed to con­ser­va­tive ther­a­py with drain­age and anti­bi­o­tics.
Conclusions. These find­ings sug­gest that pop­li­teal aneu­rysms with good dis­tal run­-off ­should be ­repaired elec­tive­ly. Completely throm­bosed aneu­rysms with coex­is­tent limb-threat­en­ing ischae­mia ­should be treat­ed initial­ly by throm­bol­y­sis. This will usu­al­ly ­restore run-­off and in some cases ­offers a valid alter­na­tive to emer­gen­cy sur­gery for limb sal­vage.

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