[Value of the posterior route in the surgical treatment of popliteal aneurysm].
The authors report about 4 cases of surgical treatment of popliteal aneurysms through a strictly posterior approach. In all cases, the aneurysm was asymptomatic and diagnosed during the assessment of a controlateral symptomatic popliteal aneurysm that was treated in a conventional manner (exclusion and interposition of a femoropopliteal prosthetic tube through a medial approach). The procedure is carried out with the patient in ventral decubitus, and it consists in a debridement and graft with direct anatomical interposition of a straight PTFE tube. The posterior approach has limitations as it does not allow craniad extension and applies only to sacciform or short fusiform aneurysms the upper pole of which does not extend beyond Hunter's canal. The graft was an 8-mm PTFE straight tube in all 4 cases. All patients had a dynamic bilateral control angiography made and none of them presented with symptoms. Three conventional restorations required later embolectomy for thrombosis of the prosthesis. In our opinion, the use of the posterior approach for the surgery of popliteal aneurysm is appealing-provided strict criteria (aneurysm size, scheduled surgery, prosthesis) are complied with--as it reduces morbidity, restores the anatomical course and allows reducing the rate of postoperative thrombosis, thus ensuring better long-term patency.
Babatasi
G
G
Service de Chirurgie Thoracique et Cardio-Vasculaire, CHU de Caen.
Rossi
A
A
Massetti
M
M
Kapadia
N
N
Maiza
D
D
Khayat
A
A
Evrard
C
C
D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D000792:Angiography; D001807:Blood Vessel Prosthesis; D006801:Humans; D011152:Popliteal Vein / Q000000981:diagnostic imaging / Q000601:surgery*
Intérêt de la voie postérieure dans la cure chirurgicale des anévrysmes poplités.