Limb salvage and popliteal aneurysms: advantages of preventive surgery.
OBJECTIVE
to assess the prognosis of atherosclerotic popliteal aneurysms (APAs), according to whether they were occluded or patent at the time of diagnosis.


METHODS
retrospective study.


METHODS
fifty-two APAs were investigated in 35 patients. Nineteen were occluded (group I) and 33 patent (group II). In group I, 11 lower limbs had critical ischaemia, and eight had severe claudication. In group II, 27 were asymptomatic, 3 were painful, and 3 presented with symptomatic distal occlusion. In group I, treatment consisted of six bypasses, five thrombectomies, four thrombolyses, but for five APAs, no revascularisation was possible due to lack of runoff. In group II, 30/33 APAs were treated by graft replacement; the other three were not operated on due to the patients>> poor general condition.


RESULTS
the 4-year survival rate was 72% in group I vs. 77% in group II, and the limb salvage rate was 72% in group I vs. 100% in group II, p<0.01.


CONCLUSIONS
prophylactic treatment of asymptomatic popliteal aneurysms may avoid amputation caused by thrombosis and embolisation of runoff.
Gouny
P
P
University of Paris VI, Tenon Hospital, Paris, France.
Bertrand
P
P
Duedal
V
V
Cheynel-Hocquet
C
C
Lancelin
C
C
Escourolle
F
F
Nussaumeand
O
O
Vayssairat
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D000783:Aneurysm / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D000792:Angiography; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control*; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex