Factors influencing the clinical course of popliteal artery aneurysm

The literature concerning the threshold for intervention in asymptomatic popliteal aneurysm is inconsistent. The purpose of this study was to identify factors related to the clinical course of popliteal aneurysms.

We analyzed the influence of patients' age and sex, diameter of the aneurysm, atherosclerotic risk factors, use of antiplatelet medications and statins, lipid profile, and the presence of other aneurysms on the symptoms and status of the popliteal aneurysm (patent or thrombosed).

Of 86 cases of popliteal aneurysms in 61 patients, 18 were asymptomatic, 22 were associated with intermittent claudication, 26 with acute limb ischemia, 10 with critical limb ischemia, and 10 with nonischemic symptoms. There was a trend of borderline statistical significance for smaller diameter in asymptomatic popliteal aneurysms. It was not possible to discriminate between cases with and without limb-threatening symptoms, or patent versus thrombosed popliteal aneurysm based on the diameter of the aneurysm. The 58 cases with hypercholesterolemia less frequently presented with limb-threatening symptoms (32.8%) compared with the 28 patients without hypercholesterolemia (60.7%, P=.02), and more often had patent aneurysms (55.2% versus 28.6%, P=.04). Patients with patent popliteal aneurysms were younger (P=.047) and were more frequently on statins (30% versus 12.5%, P=.063).

Expectations regarding clinical course and indications for intervention in popliteal aneurysm should not be based on its diameter. Statins may have a beneficial influence on the clinical course of popliteal aneurysms, but further investigations are required.