Emergency Endovascular Treatment of Popliteal Aneurysms

Abstract

Popliteal artery aneurysm (PAA), despite being rare, is the most common peripheral aneurysm. It can present as acute thrombosis and occlusion of the aneurysmal segment, and distal embolization, causing either chronic or acute limb ischemia. It has traditionally been treated with open surgical reconstruction. Endovascular repair of PAAs has recently been applied electively with a favourable early and mid-term outcome; however there is a lack of reports on the endovascular treatment of PAAs presenting with acute complications. This report describes the treatment of a thrombosed PAA in a 58 year old male using an endovascular stent-graft and also provides a systematic review of the literature on the emergency endovascular treatment of PAAs.

Endovascular Treatment with Primary Stenting of Acutely Thrombosed Popliteal Artery Aneurysms

“…Furthermore, only a few cases report primary endovascular approach to thrombosed PAAs without pre-operative thrombolysis, and the majority of them are included in single centres series without a clear definition of indications. 3,11 In our series, we assessed the feasibility of primary stenting technique in selected patients. An accurate pre-operative duplex ultrasound selection of patients is crucial for the technical success as an appropriate distal landing zone and the patency of at least one belowthe-knee vessel are mandatory.…”

“…Only anecdotal cases concerning primary stenting of thrombosed PAAs without a pre-operative intra-arterial thrombolysis are reported. [3][4][5][6] We describe our series of six patients treated with this technique for acutely thrombosed PAAs. All the patients gave their consent to the scientific use of clinical data.…”