Defining Popliteal Artery Aneurysm: A Systematic Review of the Morphological Assessment Used for Diagnosis and...

Determining the maximum diameter of popliteal artery aneurysms (PAAs) is crucial for the diagnosis and treatment of asymptomatic ones. However, PAA assessment is not standardized. Therefore, we reviewed the definitions, measurements, and morphological characteristics of PAA.

A systematic literature review was conducted using PubMed, EMBASE, Cochrane Library, Web of Science, ClinicalTrials.Gov, and ICTRP databases between 2010 and 2024, focusing on morphological assessment and PAA terminology.

Of 1,438 studies, a total of 108 met the inclusion criteria and provided morphological data on PAA with a specified aneurysm diameter. Of these, 69% (75 studies) lacked a specific PAA definition, 15% (16 studies) used absolute diameter thresholds (7-20 mm), 8% (9 studies) defined PAA based on the relative diameter, and 7% (8 studies) used absolute and relative criteria. Sixty-two percent (67 studies) employed multiple imaging modalities, whereas 17% (18 studies) used solely ultrasonography. Among the studies reporting the PAA diameter, 92% (99 studies) did not specify the measurement method, with the remainder showing considerable variability. Twenty-seven percent (29 studies) reported additional morphological details, most commonly the aneurysm length (18%). Local thrombus was noted in 55% (59 studies), and tibial flow was assessed in 81% (88 studies).

There is no agreed-upon terminology for the term PAA. The definitions are inconsistent, and morphological assessments are heterogeneous in the current literature. Standards for reporting PAA are required. Until a consensus is reached, studies should provide detailed morphological descriptions and clearly report the measurement method.