Ruptured popliteal artery aneurysm. BJS 2018; 105: 1753-1758.
Published: 24th July 2018
Authors: A. Cervin, H. Ravn, M. Björck
Popliteal artery aneurysms (PAAs) are generally complicated by thrombosis and distal embolization, whereas rupture is rare. The aim of this study was to describe the clinical characteristics and outcome in a cohort of patients who had surgery for ruptured PAA (rPAA).
Operations for rPAA were identified from the Swedish Vascular Registry, Swedvasc, 1987–2012. Medical records and imaging were reviewed. Comparison was made with patients treated for PAA without rupture.
Forty‐five patients with rPAA were identified. The proportion with rupture among those operated on for PAA was 2·5 per cent. Patients with rPAA were 8 years older (77·7 versus 69·7 years; P < 0·001), had more lung and heart disease (P = 0·003 and P = 0·019 respectively), and a larger mean popliteal aneurysm diameter (63·7 versus 30·9 mm; P < 0·001) than patients with PAA treated for other indications. At time of surgery, 22 of 45 patients were already receiving anticoagulants, seven for concomitant deep venous thrombosis (DVT) in the affected leg. There was extensive swelling of the whole leg in 20 patients. In 27 patients, the initial diagnosis was DVT or a Baker's cyst. All patients underwent surgery, all but three by the open method. There were four amputations, all performed within 1 week of surgery. One year after surgery, 26 of the 45 patients were alive. Among these, the reconstructions were patent in 20 of 22 patients.
The diagnosis of rPAA is difficult, and often delayed. The condition affects old patients, who often are on anticoagulation treatment and have large aneurysms. The immediate surgical results are acceptable, but the condition is associated with a high risk of death within the first year after surgery.Full text
You may also be interested in
Authors: A. Saratzis, N. E. M. Jaspers, B. Gwilym, O. Thomas, A. Tsui, R. Lefroy et al.
Predicting reamputation risk in patients undergoing lower extremity amputation due to the complications of peripheral artery disease and/or diabetes. BJS 2019; 106: 1026-1034.
Authors: J. M. Czerniecki, M. L. Thompson, A. J. Littman, E. J. Boyko, G. J. Landry, W. G. Henderson et al.
Health gains, costs and cost‐effectiveness of a population‐based screening programme for abdominal aortic aneurysms. BJS 2019; 106: 1043-1054.
Authors: N. Nair, G. Kvizhinadze, G. T. Jones, R. Rush, M. Khashram, J. Roake et al.
Randomized clinical trial
Randomized clinical trial of endovenous laser ablation versus direct and indirect radiofrequency ablation for the treatment of great saphenous varicose veins. BJS 2019; 106: 998-1004.
Authors: S. A. S. Hamann, L. Timmer‐de Mik, W. M. Fritschy, G. R. R. Kuiters, T. E. C. Nijsten, R. R. Bos et al.
Development and validation of a gene expression test to identify hard‐to‐heal chronic venous leg ulcers. BJS 2019; 106: 1035-1042.
Authors: D. C. Bosanquet, A. J. Sanders, F. Ruge, J. Lane, C. A. Morris, W. G. Jiang et al.
Meta‐analysis of the outcomes of treatment of internal carotid artery near occlusion. BJS 2019; 106: 665-671.
Authors: A. J. A. Meershoek, E. E. Vries, D. Veen, H. M. Ruijter, G. J. Borst, A. Garcia‐Pastor et al.
Contemporary prevalence of carotid stenosis in patients presenting with ischaemic stroke. BJS 2019; 106: 872-878.
Authors: S. F. Cheng, M. M. Brown, R. J. Simister, T. Richards
Baseline findings of the population‐based, randomized, multifaceted Danish cardiovascular screening trial (DANCAVAS) of men aged 65–74 years. BJS 2019; 106: 862-871.
Authors: J. S. Lindholt, L. M. Rasmussen, R. Søgaard, J. Lambrechtsen, F. H. Steffensen, L. Frost et al.
Randomized clinical trial
Randomized clinical trial of mechanochemical and endovenous thermal ablation of great saphenous varicose veins. BJS 2019; 106: 548-554.
Authors: S. Vähäaho, O. Mahmoud, K. Halmesmäki, A. Albäck, K. Noronen, P. Vikatmaa et al.
Meta‐analysis of long‐term survival after elective endovascular or open repair of abdominal aortic aneurysm. BJS 2019; 106: 523-533.
Authors: R. M. A. Bulder, E. Bastiaannet, J. F. Hamming, J. H. N. Lindeman
Mortality prediction following non‐traumatic amputation of the lower extremity. BJS 2019; 106: 879-888.
Authors: D. C. Norvell, M. L. Thompson, E. J. Boyko, G. Landry, A. J. Littman, W. G. Henderson et al.
Meta‐analysis of clinical trials examining the benefit of structured home exercise in patients with peripheral artery disease. BJS 2019; 106: 319-331.
Authors: J. Golledge, T. P. Singh, C. Alahakoon, J. Pinchbeck, L. Yip, J. V. Moxon et al.