[The thrombosed popliteal aneurysm: a problem for the interventional radiologist].

Area of Science:

• Vascular Surgery
• Diagnostic Imaging
• Radiology

Background:

• Aneurysms of the popliteal artery can present clinically and angiographically similar to simple vascular occlusions.
• Accurate diagnosis is critical as treatment differs significantly, with surgery being preferred for aneurysms over recanalization therapies.

Purpose of the Study:

• To evaluate the utility of contrast-enhanced computed tomography (CT) and real-time sonography in differentiating thrombosed popliteal artery aneurysms from simple vascular occlusions.
• To assess the diagnostic accuracy of these imaging modalities in detecting popliteal artery aneurysms.

Main Methods:

• Retrospective analysis of 26 patients with angiographically proven unilateral popliteal occlusion.
• Contrast-enhanced CT was used to identify aneurysms.
• Real-time sonography was employed to confirm thrombosed aneurysms.

Main Results:

• Contrast CT identified aneurysms in 11 of 26 patients (unilateral in 7, bilateral in 4).
• Real-time sonography confirmed unilateral thrombosed aneurysms in 10 of 11 cases and detected partially thrombosed contralateral aneurysms in all 4 bilateral cases.
• Palpable findings were found to be unreliable for diagnosis.

Conclusions:

• Both CT and ultrasound (US) are valuable tools for detecting aneurysmal degeneration of the popliteal artery, outperforming physical examination.
• Excluding popliteal artery aneurysm is essential before planning recanalization interventions.
• A history of abdominal aorta or femoral artery aneurysm may aid in patient selection for imaging studies.