title: Ligation-and-bypass technique through the posterior approach for bilateral popliteal aneurysms.
abstract: A 56-year-old man with a painful, progressively enlarging pulsatile mass in the bilateral popliteal fossae was diagnosed with a bilateral popliteal artery aneurysm (PAA) and referred to our hospital to undergo surgical therapy. Computed tomographic scanning demonstrated a large, middle-type PAA with a rich mural thrombus in the bilateral popliteal arteries. Following aneurysm exclusion posteriorly, the patient underwent bypass surgery using a ringed polytetrafluoroethylene graft bilaterally. This procedure was chosen to prevent nerve injury caused by mobilization of the adherent nerves and aneurysmal resection. The patient had a satisfactory postoperative course. This procedure may be recommended for large, middle-type PAAs because (1) the adherent tibial nerve trunk and its branch nerves can be protected by aneurysm exclusion with arterial branch ligation and (2) frequently occurring postexclusion expansion of the aneurysm caused by insufficient branch ligation using the medial approach can be avoided.
authors.affiliation: Department of Cardiovascular Surgery, Akita University School of Medicine, Akita, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Fumio
authors.initials: F
authors.lastname: Yamamoto
authors.forename: Keiji
authors.initials: K
authors.lastname: Seki
authors.forename: Keisuke
authors.initials: K
authors.lastname: Shiroto
authors.forename: Gembu
authors.initials: G
authors.lastname: Yamaura
authors.forename: Mamika
authors.initials: M
authors.lastname: Motokawa
authors.forename: Fuminobu
authors.initials: F
authors.lastname: Tanaka
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Izumoto
mesh_terms: D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011474:Prosthesis Design; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation
chemical_list: D011138:Polytetrafluoroethylene