Popliteal aneurysms. A clinical appraisal.

From 1950 to 1980, 49 popliteal aneurysms in 34 patients have been treated at the University of Tennessee Center for the Health Sciences. A retrospective analysis of these patients' records revealed that 88 per cent of these aneurysms and 40 per cent of patients had synchronous or metachronous development of aneurysms in other locations. At the time of diagnosis, 22 per cent of patients were truly asymptomatic, and 36 per cent presented with claudication. Approximately one third of patients presented with an acute limb-threatening complication, e.g., thrombosis, embolization, or rupture. Limb salvage rates were worse in patients with thrombosis (45%) and embolization (75%). The diagnosis was made on physical examination in all patients, with arteriography and ultrasonography proving to be useful adjuncts. This analysis supports proximal and distal aneurysmal ligation with reversed saphenous vein bypass as the procedure of choice. Asymptomatic aneurysms should be repaired based on a significant incidence of limb-threatening complications when untreated and a superior patency rate following surgical management.