Follow-up of the aneurysmal sac after exclusion and bypass of popliteal artery aneurysms.
Popliteal artery aneurysms are frequent and may lead to thromboembolic events and limb loss.


OBJECTIVE
To evaluate clinical and ultrasonographic follow-up of patients who underwent exclusion of a popliteal artery aneurysm using the technique proposed by Edwards.


METHODS
Data of all patients who underwent surgery to repair a popliteal artery aneurysm at Hospital das Clinicas, the São Paulo University Medical School between 1996 and 2004 were reviewed. Inclusion criteria were repair with aneurysm exclusion and bypass using the technique proposed by Edwards, as well as the existence of preoperative and postoperative measurements of the aneurysmal sac.


RESULTS
Data of 16 patients who underwent 20 procedures for popliteal artery aneurysm exclusion and bypass were available to analysis. The preoperative diameter of the popliteal artery aneurysms ranged from 1.3 cm to 6.1 cm (mean = 3.1 cm). Patients underwent duplex ultrasound scanning 1 month to 7 years after surgical repair. Follow-up of the 20 cases revealed that 10 aneurysms exhibited decreased mean transverse diameters, ranging from 0.2 to 2.3 cm, while 7 had increased in diameter, ranging 0.3 to 3.3 cm, and 3 remained unchanged. Flow was observed only in 5 out of the 20 procedures, 3 of which (60%) had increased diameters.


CONCLUSIONS
Although exclusion is a widely accepted procedure for the repair of popliteal artery aneurysms, data in the literature and the results of this study, which did not include cases of rupture or compression, suggest that strict follow-up of patients who undergo aneurysm exclusion is necessary.
Wakassa
Tais Bugs
TB
Department of Vascular Surgery, Hospital das Clinicas, São Paulo University Medical School, São Paulo, SP, Brazil. tbugs@terra.com.br
Matsunaga
Patrícia
P
da Silva
Erasmo Simão
ES
Pinto
Carlos A
CA
Kauffman
Paulo
P
Aun
Ricardo
R
Puech-Leão
Pedro
P