[Popliteal aneurysm and leg ischemia: surgery first]

The treatment of symptomatic popliteal aneurysms is debated should local fibrinolysis or surgery first be used first? The authors report their experience in the treatment of 90 popliteal aneurysms in 66 patients. In this series were only examined those aneurysms with either acute ischaemia 12 (27%) or sub-acute ischaemia 21 (45%). The treatment of those cases with acute ischaemia was surgical for all, allowing salvage in all cases. Sub-acute ischaemia was treated with either: a surgical bypass with exclusion of the aneurysm in 7 cases, or lumbar sympathectomy in 7 cases, or medical treatment in 6 cases or local fibrinolysis for distal ischaemia in one case only. There was no peri-operative mortality, only one amputation was required (5%) (J Mal Vasc 1994; 19, Suppl. A: pages 150-153).