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Related Experiment Videos

Popliteal artery aneurysms: current management and outcome

J P Carpenter1, C F Barker, B Roberts

  • 1Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia.

Journal of Vascular Surgery
|January 1, 1994
PubMed
Summary

Preoperative thrombolytic therapy is beneficial for treating thrombosed popliteal artery aneurysms, improving limb salvage and graft patency. This approach offers a safer alternative to emergency surgery for acute leg ischemia.

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Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Thrombosis Management

Background:

  • Popliteal artery aneurysms (PAAs) pose a risk of limb-threatening ischemia due to thrombosis.
  • PAAs are often associated with other arterial aneurysms and can present with compression or thrombosis.

Purpose of the Study:

  • To evaluate the efficacy of preoperative thrombolytic therapy in patients with thrombosed PAAs and acute limb ischemia.
  • To compare outcomes of thrombolytic therapy followed by repair versus emergency surgery for thrombosed PAAs.

Main Methods:

  • Retrospective study of 33 patients with 54 PAAs, analyzing aneurysm characteristics and treatment outcomes.
  • Comparison of graft patency and limb salvage rates between patients treated with thrombolysis and those undergoing emergency surgery.

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  • Assessment of factors influencing graft patency and limb salvage, including runoff vessel status and aneurysm patency.

    • Main Results:

    • Five-year graft patency and limb salvage rates were 71% and 90% respectively for bypass grafting.
    • Good runoff and patent aneurysms were associated with significantly better graft patency and limb salvage.
    • Preoperative thrombolytic therapy in 7 patients with thrombosed PAAs led to complete thrombus clearing in most cases, resulting in superior graft patency and limb salvage compared to emergency surgery. No amputations occurred in the thrombolysis group.

    Conclusions:

    • Elective repair of patent PAAs with adequate runoff is the preferred management strategy.
    • For thrombosed PAAs causing acute leg ischemia, preoperative thrombolytic therapy is a safe and effective alternative to emergency surgery, improving outcomes.