Aggressive surgical management of popliteal artery aneurysms

One hundred fifty-nine patients with 244 popliteal aneurysms underwent 167 reconstructive procedures. Patients were divided into those with asymptomatic aneurysms, those with acute ischemia secondary to thrombosis or embolism, those with claudication secondary to chronic thrombosis or embolism, and those with local symptoms referable to the aneurysm itself. Patients who underwent successful revascularization were considered to have good early results. Patients with asymptomatic aneurysms had uniformly good results (97.2 percent) as opposed to those presenting with acute (70.7 percent) or chronic symptoms (83.8 percent). Similar statistically significant differences were seen when patients with thrombosis (71.7 percent) or embolism (81.3 percent) were compared with asymptomatic patients. Analysis of late results indicates that if an initial good result was obtained, the late patency rate was independent of type of presentation. Late results were affected by type of conduit employed where life table analysis showed the superiority of saphenous vein over Dacron prosthesis. At 5 year follow-up, 77.2 percent of all saphenous veins were patent whereas only 29.5 percent of Dacron prostheses remained patent.