[Elective and emergency surgical treatment of popliteal aneurysms. Indications and results].
BACKGROUND
The aim of this paper is to evaluate the long term results related to surgical technique and to prosthetic material in planned and emergency conditions.


METHODS
From January 1990 to December 1999, fourty-five patients with popliteal aneurysms were observed. Eighteen patients (40%) were asymptomatic; eleven (24.4%) suffered from claudicatio; six had an acute ischemia (13.3%) and four presented (8.9%) clinical signs of rest pain; in four cases (8.9%) symptoms were related to venous compression and to rupture in two (4.4%). Diagnosis was obtained by ultrasounds, angiography and CT-scan. All patients were operated on and in four cases (8.9%) the procedure involved both legs. The prosthetic material was reversed autologous saphenous vein (ASV) in 30 patients (61.2%), PTFE-EXS-TW in 16 (32.6%), homologous vein in one (2%), composite graft in one (2%), and a Dacron in the last one (2%).


RESULTS
Six patients died for causes not related to the operation and eight bypasses (18.2%) became occluded. Amputation was needed in two patient, in relation to late bypass occlusion. In one cases an amputation was carried out for acute thrombosis of the contralateral aneurysm which was not treated for patients refusal. The long term patency rate was 81.8%.


CONCLUSIONS
Popliteal aneurysms must be considered for reconstructive surgery, also when asymptomatic and with a diameter over 2 cm. The routinely use of the ASV improves the long-term patency rate. Best long term results are obtained in elective surgery.
Irace
L
L
II Cattedra di Chirurgia Vascolare, Università degli Studi La Sapienza, Rome, Italy.
Gattuso
R
R
Faccenna
F
F
Cappello
F
F
Siani
A
A
Stumpo
R
R
Boiceff
S
S
Benedetti-Valentini
F
F
D000783:Aneurysm / Q000601:surgery*; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D011150:Popliteal Artery / Q000601:surgery*; D013997:Time Factors