Vascular: Popliteal Aneurysm

Question 1

What is the pathophysiology of a popliteal aneurysm

Answer 1

50% larger than its normal diameter

one of the most common sites for peripheral aneurysms

Question 2

Outline the aetiology of a popliteal aneurysm

Answer 2

Trauma

Infection

CT disease (Marfan’s)

Inflammatory disease

Question 3

What risk factors are associated with a popliteal aneurysm?

Answer 3

Smoking

HTN

Hyperlipidaemia

FH

Question 4

Describe the symptoms of a popliteal aneurysm

Answer 4

Acute limb ischemia (from aneurysm thrombosis or distal emboli)

Intermittent claudication = less common

Pulsatile mass in popliteal fossa

Often found bilaterally

Associated with abdominal aortic aneurysms (20%)

Question 5

What investigations should be performed for a suspected popliteal aneurysm?

Answer 5

US duplex = useful for detection and follow up, allows for differentiation between other causes of a popliteal fossa swelling (bakers cyst, lympthadenopathy)

CT angiography = gold standard, asses patency and operative planning

MR angiography

Question 6

How are popliteal aneurysms managed?

Answer 6

High risk for embolization so active management is advised

Endovascular repair = stent insertion across the aneurysm under local anaesthetic

Surgical repair = ligation of the aneurysm or resection of the aneurysm with a bypass graft (either a vein from the patient (preferred) or a graft)

Question 7

What are the possible complications of a popliteal aneurysm?

Answer 7

High risk embolization

Rupture is rare