Endovascular therapy for a ruptured popliteal aneurysm

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Emergency Medicine

Background:

• Popliteal artery aneurysms (PAA) are rare but can lead to severe complications like limb ischemia or rupture.
• Rupture is an uncommon PAA complication, occurring in less than 3% of cases, often presenting with critical limb symptoms.
• Giant PAAs, defined by a diameter greater than 2 cm, warrant intervention due to increased risk of thrombosis and embolization.

Observation:

• An 88-year-old male presented with acute limb swelling and pain due to a ruptured giant PAA (9.1 cm diameter) with significant thigh hematoma.
• The patient's general condition was critical, complicated by acute respiratory insufficiency.
• Urgent endovascular repair was performed successfully under local anesthesia.

Findings:

• Endovascular repair of a ruptured giant popliteal artery aneurysm can be technically successful even in critically ill patients.
• Despite successful aneurysm repair, the patient died on the second postoperative day due to respiratory failure, highlighting the challenges of managing comorbidities.
• The case underscores that while endovascular repair is a viable option for selected PAA patients, outcomes are influenced by overall patient condition.

Implications:

• This case highlights the potential of endovascular techniques in managing complex vascular emergencies like ruptured giant PAAs.
• It emphasizes the importance of comprehensive patient assessment, including comorbidities, when considering surgical interventions for PAA.
• Further research into the long-term outcomes and patient selection criteria for endovascular PAA repair is warranted, especially in high-risk populations.