Diagnosis and Treatment of Popliteal Aneurysm： Report of 11 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

MA Yukui , ZHAO Jichun , WANG Jing , JIN Liren.

Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

Popliteal aneurysm; Diagnosis; Treatment

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Objective　To present and summarize the data concerning the diagnosis and treatment of popliteal aneurysm in our hospital. Methods　The data of popliteal aneurysm in our hospital from 1975 to 2004 were reviewed and analyzed. Eleven patients with 11 diseased limbs were treated, including 8 males and 3 females, age from 21 years to 64 years 〔(48.54±13.66) years〕. The combined diseases include syphilis, rheumatic heart disease and chronic obstructire pulmonary disease etc. Ten patients received operations, including endoaneurysmorrhaphy (n=4) and graft bypass after aneurysmal resection (n=6), through posterior approach (n=7) or medial approach (n=3). One patient, combined with advanced syphilis and heart failure, received conservative treatment because of his poor general condition. Results　The common clinical manifestations included popliteal pulsating mass, claudication, difficulty in extension of the knee, pain etc. Acute ischemia occurred in 3 limbs. The diameter of popliteal aneurysms varied from 4-13 cm 〔（6.73±2.69) cm〕. There were 3 (27.3%) cases of ruptured aneurysms whose diameters were 7 cm, 7 cm and 11 cm respectively. Special examinations included arteriography and Doppler sonography. Pathological results of these patients were pseudoaneurysm (n=3), syphilitic aneurysm (n=3) and atherosclerotic aneurysm (n=4). Two patients were not followed up, and postoperative follow up of the other 8 patients ranged from 18 months to 30 years. In the group of endoaneurysmorrhaphy, postoperative gangrene of the affected limb occurred in one patient, and above-knee amputation was performed. One patient suffered from intermittent claudication in the group of endoaneurysmorrhaphy and of graft bypass respectively. No manifestations of limb ischemia were found in the other 5 patients during the time of follow up. Conclusion　General utilization of Doppler sonography in screening high risk patients might be helpful to detect popliteal aneurysm. For symptomatic popliteal aneurysm or asymptomatic popliteal aneurysm with diameter larger than 3 cm, operation is indicated. Asymptomatic popliteal aneurysms no more than 3 cm in diameter could be monitored with care.

Citation： MA Yukui,ZHAO Jichun,WANG Jing,JIN Liren.. Diagnosis and Treatment of Popliteal Aneurysm： Report of 11 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2006, 13(6): 656-658. doi: Copy

1.	Martelli E, Ippoliti A, Ventoruzzo G, et al. Popliteal artery aneurysms. Factors associated with thromboembolism and graft failure [J]. Int Angiol, 2004; 23(1)∶54.
2.	Vermilion BD, Kimmins SA, Pace WG, et al. A review of one hundred forty-seven popliteal aneurysms with long-term follow-up [J]. Surgery, 1981; 90(6)∶1009.
3.	王正周. 大隐静脉移植治疗腘动脉瘤一例 [J]. 中国修复重建外科杂志， 1998; 12(6)∶349.
4.	谢小平, 曾　强. 腘动脉瘤血栓形成致小腿坏死1例 [J]. 四川医学， 2005; 26(1)∶24.
5.	郭大勇. 巨大腘动脉瘤切除1例报告 [J]. 华北煤炭医学院学报， 2001; 3(1)∶61.
6.	李　军, 黄流清. 腘动脉瘤压迫致胫神经损害1例报告 [J]. 临床神经病学杂志， 2005; 18(2)∶145.
7.	Dawson I, Sie RB, van Bockel JH. Atherosclerotic popliteal aneurysm [J]. Br J Surg, 1997; 84(3)∶293.
8.	Galland RB, Magee TR. Management of popliteal aneurysm [J]. Br J Surg, 2002; 89(11)∶1382.
9.	Davidovic LB, Lotina SI, Kostic DM, et al. Popliteal artery aneurysms [J]. World J Surg， 1998; 22(8)∶812.
10.	Carpenter JP, Barker CF, Roberts B, et al. Popliteal artery aneurysms: current management and outcome [J]. J Vasc Surg， 1994; 19(1)∶65.
11.	Ascher E, Markevich N, Schutzer RW, et al. Small popliteal artery aneurysms: are they clinically significant? [J].J Vasc Surg， 2003; 37(4)∶755.
12.	Mahmood A, Salaman R, Sintler M, et al. Surgery of popliteal artery aneurysms: a 12-year experience [J]. J Vasc Surg， 2003; 37(3)∶586.
13.	Robert B. Rutherford Eds. Rutherford vascular surgery [M]. 1st ed. Beijing: People’s Medical Publishing House， 2002∶1345-1356.

1. 　Martelli E, Ippoliti A, Ventoruzzo G, et al. Popliteal artery aneurysms. Factors associated with thromboembolism and graft failure [J]. Int Angiol, 2004; 23(1)∶54.
2. 　Vermilion BD, Kimmins SA, Pace WG, et al. A review of one hundred forty-seven popliteal aneurysms with long-term follow-up [J]. Surgery, 1981; 90(6)∶1009.
3. 　王正周. 大隐静脉移植治疗腘动脉瘤一例 [J]. 中国修复重建外科杂志， 1998; 12(6)∶349.
4. 　谢小平, 曾　强. 腘动脉瘤血栓形成致小腿坏死1例 [J]. 四川医学， 2005; 26(1)∶24.
5. 　郭大勇. 巨大腘动脉瘤切除1例报告 [J]. 华北煤炭医学院学报， 2001; 3(1)∶61.
6. 　李　军, 黄流清. 腘动脉瘤压迫致胫神经损害1例报告 [J]. 临床神经病学杂志， 2005; 18(2)∶145.
7. 　Dawson I, Sie RB, van Bockel JH. Atherosclerotic popliteal aneurysm [J]. Br J Surg, 1997; 84(3)∶293.
8. 　Galland RB, Magee TR. Management of popliteal aneurysm [J]. Br J Surg, 2002; 89(11)∶1382.
9. 　Davidovic LB, Lotina SI, Kostic DM, et al. Popliteal artery aneurysms [J]. World J Surg， 1998; 22(8)∶812.
10. 　Carpenter JP, Barker CF, Roberts B, et al. Popliteal artery aneurysms: current management and outcome [J]. J Vasc Surg， 1994; 19(1)∶65.
11. 　Ascher E, Markevich N, Schutzer RW, et al. Small popliteal artery aneurysms: are they clinically significant? [J].J Vasc Surg， 2003; 37(4)∶755.
12. 　Mahmood A, Salaman R, Sintler M, et al. Surgery of popliteal artery aneurysms: a 12-year experience [J]. J Vasc Surg， 2003; 37(3)∶586.
13. 　Robert B. Rutherford Eds. Rutherford vascular surgery [M]. 1st ed. Beijing: People’s Medical Publishing House， 2002∶1345-1356.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis and Treatment of Popliteal Aneurysm： Report of 11 Cases

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