Management of popliteal aneurysm.
BACKGROUND
The best management of patients with a popliteal aneurysm has yet to be established. This paper describes an experience of managing both patent and acutely thrombosed popliteal aneurysms.


METHODS
A prospective study was carried out of all patients who presented with a popliteal aneurysm from January 1988 to December 2001. Since 1993 asymptomatic popliteal aneurysms less than 3 cm in diameter without distortion have been managed conservatively. Ultrasonography was repeated at 6-month intervals. These results were compared with conservative management of popliteal aneurysms greater than 3 cm in diameter in patients who declined or were unfit for operation, and with the outcome of patients who underwent elective bypass of a popliteal aneurysm.


RESULTS
Fifty-eight patients (two women) presented with 92 popliteal aneurysms. Some 39 had a thrombosed aneurysm and these patients were significantly more likely to have bilateral aneurysms (P < 0.001). Of patent popliteal aneurysms managed conservatively, none below 3 cm in diameter thrombosed. The risk of postoperative complications was greater after repair of a thrombosed than a patent aneurysm (P < 0.005). Preoperative lysis for a thrombosed popliteal aneurysm was associated with more complications than operation and on-table lysis (P < 0.05).


CONCLUSIONS
Careful monitoring of asymptomatic popliteal aneurysms less than 3 cm in diameter is safe. Preoperative lysis is associated with increased risks compared with operation alone in patients with a thrombosed popliteal aneurysm.
Galland
R B
RB
Department of Surgery, Royal Berkshire Hospital, Reading RG1 5AN, UK. robert.galland@rbbh-tr.anglox.nhs.uk
Magee
T R
TR
D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D011446:Prospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome; D014654:Vascular Patency