Popliteal Aneurysm

Question 1

What classifies as a popliteal aneurysm

Answer 1

Popliteal artery 2cm or more in diameter

Question 2

What proportion of patients with one popliteal aneursym will have bilateral aneurysms?

Answer 2

50%

Question 3

How might a patient with a popliteal aneurysm present

Answer 3

Lump behind the knee - if the aneurysm has grown large enough and extended beyond the popliteal fossa
50% present with distal limb ischaemia - caused by thrombosis or embolism
Patients may present with acutely ischaemic leg

Question 4

What percentage of all peripheral aneurysms are popliteal

Answer 4

80%

Question 5

What percentage of popliteal aneurysms rupture

Answer 5

Less than 10%

Question 6

What are the indications for surgery for a popliteal aneurysm

Answer 6

Symptomatic aneurysms
Those containing thrombus
Those greater than 2cm

Question 7

How do you surgically manage a popliteal aneurysm

Answer 7

Acute: Embolectomy or fem-distal bypass

Stable:
Excision bypass - popliteal artery ligated above and below the disease segment and a graft interposed

Simple resection and anastomosis - Hunter’s ligation (no graft used)

Question 8

How would you manage acute ischaemia due to a thrombus in a patient with a popliteal aneurysm

Answer 8

Thrombolysis

Question 9

What percentage of patients with a AAA also have a popliteal aneurysm

Answer 9

10-15%

Question 10

What investigations would you do on a patient with a popliteal aneurysm

Answer 10

Ultrasound

Angiogram - if planning surgery

Question 11

What percentage of patients with a popliteal aneurysm have an AAA?

Answer 11

50%