Unique Case of a 6 centimetre Ruptured Popliteal Artery Aneurysm Causing Thigh Compartment Syndrome

Area of Science:

• Vascular Surgery
• Trauma Surgery
• Radiology

Background:

• Popliteal artery aneurysms (PAAs) are rare vascular conditions.
• PAA rupture typically does not cause rapid hemodynamic instability due to anatomical resistance.
• Thigh compartment syndrome following PAA rupture is an exceptionally rare complication.

Purpose of the Study:

• To highlight a rare sequela of popliteal artery aneurysm rupture: thigh compartment syndrome with hemodynamic compromise.
• To report a unique case of a ruptured PAA leading to significant thigh hematoma and compartment syndrome.
• To emphasize the successful management of this rare complication.

Main Methods:

• Case report of an 81-year-old male with a ruptured PAA.
• Computed tomography angiography (CTA) for diagnosis and characterization of the PAA and hematoma.
• Urgent endovascular repair using a covered stent followed by fasciotomies.

Main Results:

• The patient presented with hemodynamic compromise and thigh compartment syndrome secondary to PAA rupture.
• CTA confirmed a ruptured PAA with a large posterior thigh hematoma.
• Endovascular repair and fasciotomies were performed successfully, leading to limb salvage and hemodynamic stabilization.

Conclusions:

• Endovascular repair with a covered stent is a safe and effective option for high-risk, unstable patients with ruptured PAAs.
• This approach allows for rapid aneurysm exclusion, limb salvage, and hemodynamic stabilization.
• This case underscores the importance of considering compartment syndrome in PAA rupture, even with atypical presentations.