Popliteal aneurysm: a review of 116 cases

Abstract

One hundred and sixteen cases of popliteal aneurysm have been studied. The condition most commonly represents a local manifestation of generalized degenerative arterial disease, either occlusive or dilating. In the latter instance the condition is more often bilateral and there is a higher incidence of aortic aneurysm. Symptoms occur from complications irrespective of the size of the aneurysm. The results of reconstructive operations in false aneurysrns are bad, and unless there is good cause to consider that some form of reconstruction would be successful a lumbar sympathectomy is probably the best treatment. Operation should be advised in all cases with a patent aneurysm and in those with a thrombosed aneurysm and patent tibia1 vessels. In cases with tibial vessel obstruction due to embolism, clearance can often be effected by the use of an embolectomy catheter to allow distal anastomosis. When a popliteal aneurysm is a manifestation of generalized dilating disease the results of surgery are excellent and long lasting, but if there is generalized stenosing disease the results are the same as after operation for diffuse atherosclerosis. In patients with bilateral popliteal aneurysms, one of which is complicated, the uncomplicated one should probably be operated upon first, although sometimes both may be done at the same session. Sympathectomy seems a worth-while operation in patients in whom no distal vessel is available for anastomosis, and other proximal reconstructions may be indicated, particularly when diffuse stenosing disease is present.