Late complications after ligation and bypass for popliteal aneurysm.
BACKGROUND
Ligation and bypass is standard treatment for popliteal aneurysm. This technique does not abolish collateral circulation to the aneurysm, which may continue to expand and/or rupture. This study assessed whether complete thrombosis of the aneurysm sac occurs after operation and examined the long-term clinical outcome.


METHODS
The records of all patients who underwent popliteal aneurysm repair in a university hospital over 10 years were reviewed. Patients who had undergone ligation and bypass were recalled for clinical and ultrasonographic examination to determine the fate of the aneurysm sac.


RESULTS
Persistent blood flow in the aneurysm sac was present in 12 of 36 legs a median of 48 months after operation. This was associated with symptomatic enlargement of the aneurysm in six patients. The incidence of sac enlargement was lower in bypassed aneurysms with no intrasac flow on duplex examination.


CONCLUSIONS
Ligation and bypass does not always abolish blood flow in the sac of a popliteal aneurysm. It may be associated with continued expansion and late complications.
Kirkpatrick
U J
UJ
Regional Vascular Unit, Royal Liverpool University Hospital, Liverpool, UK. ujkirkpatrick@doctors.net.uk
McWilliams
R G
RG
Martin
J
J
Brennan
J A
JA
Gilling-Smith
G L
GL
Harris
P L
PL
D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000503:physiopathology / Q000601:surgery*; D001775:Blood Circulation / Q000502:physiology; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000502:physiology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D017211:Treatment Failure; D018616:Ultrasonography, Doppler, Duplex