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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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Are Small Popliteal Aneurysm so Innocent?
Roberto Gabrielli1, Andrea Siani1, Gianluca Smedile1
1Unit of Vascular, Endovascular and Emergency Vascular Surgery, "S. Eugenio" Hospital, Rome, Italy.
Annals of Vascular Surgery
|January 7, 2022
Summary
Small popliteal artery aneurysms (PAA) can cause limb-threatening ischemia. Immediate surgical intervention is crucial for managing PAA thrombosis, even for smaller aneurysms, to prevent amputation.
Area of Science:
- Vascular Surgery
- Aneurysm Research
- Ischemia Management
Background:
- Popliteal artery aneurysms (PAA) ≤20 mm diameter can lead to acute lower limb ischemia due to thrombosis.
- Small symptomatic PAAs require careful management due to associated risks.
Purpose of the Study:
- To analyze the outcomes of surgical management for small symptomatic popliteal artery aneurysms (PAA).
- To compare amputation rates between PAAs ≥20 mm and ≤20 mm.
Main Methods:
- Retrospective cohort study of 48 patients with acute leg ischemia from PAA thrombosis.
- Surgical treatment included distal thrombectomy and bypass creation.
- Patients were divided into two groups: diameter ≥20 mm (Group A) and diameter ≤20 mm (Group B).
Main Results:
- Overall two-year amputation rate was 22.9%.
- No statistically significant difference in amputation rates between Group A (21.8%) and Group B (25%).
- Amputation correlated with single runoff vessel recovery and ischemia duration exceeding 4 days.
Conclusions:
- Small popliteal artery aneurysms (PAA) are not benign and carry a significant risk of limb loss.
- Immediate surgical intervention is mandatory for PAA thrombosis, regardless of aneurysm size, especially if ischemia exceeds 2 days.
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