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Related Experiment Videos

[Popliteal aneurysm and leg ischemia: surgery first]

J L Magne1, L Voirin, A Badra

  • 1Service de Chirurgie vasculaire, CHU Grenoble.

Journal Des Maladies Vasculaires
|January 1, 1994
PubMed
Summary

Surgical intervention is recommended for acute ischemic popliteal aneurysms, ensuring limb salvage. Sub-acute cases show varied treatment outcomes, with surgery being a reliable option for popliteal aneurysm management.

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Area of Science:

  • Vascular Surgery
  • Aneurysm Treatment
  • Ischemia Management

Background:

  • Popliteal aneurysms are a significant cause of limb ischemia.
  • The optimal treatment strategy for symptomatic popliteal aneurysms remains debated.
  • Acute and sub-acute presentations require distinct management approaches.

Purpose of the Study:

  • To evaluate the outcomes of different treatment modalities for symptomatic popliteal aneurysms.
  • To compare surgical versus non-surgical interventions for sub-acute presentations.
  • To assess the efficacy of treatments in preventing amputation and ensuring limb salvage.

Main Methods:

  • Retrospective analysis of 90 popliteal aneurysms in 66 patients.
  • Categorization of aneurysms into acute (27%) and sub-acute (45%) ischemia groups.

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  • Surgical treatment for all acute ischemia cases; varied treatments (bypass, sympathectomy, medical, fibrinolysis) for sub-acute cases.

    • Main Results:

    • All 12 cases of acute ischemia were successfully treated with surgery, achieving limb salvage.
    • In sub-acute ischemia, surgical bypass (7 cases) and sympathectomy (7 cases) were employed, alongside medical treatment (6 cases) and limited fibrinolysis (1 case).
    • Overall, no peri-operative mortality and only one amputation (5%) were recorded, indicating effective management.

    Conclusions:

    • Surgery is the definitive treatment for acute ischemic popliteal aneurysms, ensuring limb salvage.
    • Sub-acute popliteal aneurysms can be managed with various strategies, including surgical exclusion and sympathectomy, with favorable outcomes.
    • The study highlights the effectiveness of surgical intervention in managing symptomatic popliteal aneurysms and preventing amputation.