Popliteal aneurysms are most common in males. Major risk factors include advancing age, smoking, and family history. Around 2/3 of patients with a popliteal aneurysm will also have an abdominal aortic aneurysm (AAA) (see Abdominal Aortic Aneurysms). Around 1/2 of patients diagnosed with a popliteal aneurysm will have one the other side.
Popliteal aneurysms may be diagnosed during clinical examination or during imaging of the lower limb arteries.Patients sometimes experience discomfort behind the knee associated with a popliteal aneurysm.
The major risk associated with a popliteal aneurysm is thrombosis (clotting off) and thromboembolism (pieces of clot travelling down the leg) causing a sudden reduction in the blood supply the leg. This is a limb-threatening emergency, which carries with it a significant a significant risk of limb loss and amputation, even with emergency surgery.Rupture of a popliteal aneurysm is a rare event, but can occur.
Popliteal aneurysms should be treated when they reach a diameter of 2cm. Aneurysms can be treated at a size less than this if they cause symptoms or are growing rapidly.The most durable treatment option for popliteal aneurysms is open surgery with an exclusion bypass (see lower limb bypass surgery). Minimally-invasive endovascular repair is an option, but the patency of the stents used in this location is not as good as bypass surgery, and is therefore reserved for patients with significant medical conditions which preclude open surgery. Endovascular repair may also not be possible due to the anatomy of the aneurysm. The choice of treatment will be discussed in detail with Mr Milne during the pre-operative consultation.
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