Ruptured popliteal artery aneurysms

Abstract

Background Rupture is a recognised complication of ruptured popliteal artery aneurysms that requires emergency intervention. There is little evidence collating the presentation, intervention and outcomes of ruptured popliteal artery aneurysms. Objective The primary aim of this study was to deduce the sequelae following different management modalities of ruptured popliteal artery aneurysm. Methods We performed a systematic review of all available cases reports of ruptured popliteal artery aneurysms in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis Protocol. Results We identified 48 cases taken from 35 case reports and series. Men were more commonly affected ( n = 96%), and mean age was 71 years. Acute limb ischemia was the commonest presentation (32%) whilst incidental deep vein thrombosis was found in 43% of patients. The mean aneurysm size was 8.2 cm (range, 2.7 to 13.3 cm). Management consisted of open surgery (58%), endovascular treatment (25%) and ‘other’ treatment (evacuation of haematoma, ligation of aneurysm, amputation or palliation) (17%). The perioperative mortality rate in the whole cohort was 13%. Perioperative mortality was similar between comparing the open and endovascular surgery groups. Re-intervention rate amongst endovascular patients was 25% over an average follow-up period of 14 months. There was one re-intervention in the re-constructive group (3%) over a follow-up period of 17 months and none in the ‘other’ group. Conclusion Popliteal artery aneurysm rupture is a serious complication associated with significant morbidity and mortality. Open surgical reconstruction and endovascular repair are both feasible for the treatment of ruptured popliteal artery aneurysms; however, open surgery is less likely to require further re-intervention.

Successful Endovascular Repair of a Ruptured Popliteal Artery Aneurysm: A Case Report and Literature Review

“…A literature review conducted at the time of submission of this case report showed 62 [2][3][4][5][6][7][8][9][10][11][12][13] reported cases of ruptured PAA. Most cases reported were males, with an age range of 55-96 and a mean age of 81.…”

“…PAA rupture is a rare but recognized presentation that requires a rapid diagnosis and treatment for limb salvage [1]. The standard treatment for such ruptures is a surgical exclusion bypass; however, a number of other management options are described in the literature [2][3][4][5][6][7][8][9][10][11][12][13]. Such options include endovascular treatment with coil embolization [10] and/or stent graft.…”

Anterograde and Retrograde Approach With Through-and-Through Wiring Technique to Treat a Ruptured and Extremely Tortuous Giant Popoliteal Artery Aneurism

“…In largest reported series, around 2-5% of PAA that have been surgically managed were found to be ruptured within the surgery. 3,4 Management has traditionally been surgically, however, in recent years considerable development of endovascular techniques and materials has added an interesting and less invasive treatment approach, particularly in high risk patients. 3,4 At a technical level, endovascular treatment consists in exclusion of the aneurism with a stent graft.…”

“…3,4 Management has traditionally been surgically, however, in recent years considerable development of endovascular techniques and materials has added an interesting and less invasive treatment approach, particularly in high risk patients. 3,4 At a technical level, endovascular treatment consists in exclusion of the aneurism with a stent graft. Technical challenges in these situations are seen when a PAA is too large, resulting in bending and kinking of adjacent artery segments, or in an acute setting such as rupturing.…”

Mycotic Popliteal Artery Aneurysm With Rapid Enlargement Post-Bypass

“…Documented microbes in their series were Salmonella spp. (3), Staphylococcus aureus (2), Escherichia coli, Campylobacter fetus, Mycobacterium bovis, Listeria, and group B Streptococcus[9].Overall, mycotic aneurysms infected with Staphylococcus epidermidis should demonstrate a generally indolent course. They may present with minimal to no clinical features of infection and are difficult to culture and diagnose.…”