Popliteal aneurysms

A 15 year experience with 50 popliteal aneurysms in 36 patients is reviewed. Forty-seven popliteal aneurysms were atherosclerotic while three were related to entrapment of the popliteal artery. Fourteen asymptomatic popliteal aneurysms were observed preoperatively during a mean period of 26 months. Ischemic complications developed in five of these. At admission, 16 limbs were asymptomatic (group 1) while the other 34 limbs presented with ischemic symptoms (group 2). No operation was performed upon three limbs, and another two were surgically explored and amputated. No operative deaths resulted from 45 vascular reconstructions. Results from follow-up study of one to 176 months (a mean of 57 months) revealed a late patency rate of 62 per cent. The late patency rate of autologous saphenous vein (ASV) was 100 per cent; polytetrafluoroethylene (PTFE) and Dacron® (polyester fiber) grafts had a patency rate of 74 and 34 per cent, respectively (ASV versus PTFE, p = N.S.; ASV versus Dacron, p < 0.002). The rate of late salvage of limbs was 88 per cent. The bypass grafts of group 1 and those performed upon limbs with good runoff fared significantly better than others (p < 0.05 and p < 0.001). The risk of natural complications of popliteal aneurysms and the good results from surgical treatment suggested that a revascularization procedure in the asymptomatic stage is always recommended. The use of PTFE grafts for repair of popliteal aneurysms is justified when the ASV is not available. The use of Dacron grafts is no longer indicated.