Risk of new aneurysms after surgery for popliteal artery aneurysm

Background: The risk of developing a new aneurysm after surgery for popliteal artery aneruysm (PAA) is not well known. The aim was to study this risk in a cohort of patients. Methods: A total of 571 patients who had primary operation for PAA (717 legs) between 1987 and 2002 were identified from the Swedish Vascular Registry (Swedvasc). Of these, 190 patients were re-examined by ultrasonography after a median of 7 (range 2.9-18.7) years. Results. The number of patients with at least one aneurysm in addition to the PAA was 108 (56.8 per cent) at the index operation and 131 (68.0 per cent) at re-examination. The overall number of aneurysms increased by 41.8 per cent, from 244 to 346. Among the 82 patients who had an isolated PAA at the index operation, 23 developed a new aneurysm; these patients tended to be older (P = 0.004). Bilateral PAA at the index operation was associated with a later development of abdominal aortic aneurysm (P = 0.004). Age (P = 0.004) and hypertension (P = 0.012) at the time of the index operation were associated with multianeurysm disease at any time. Six (4.3 per cent) of 138 legs treated by venous bypass grafts had developed a graft aneurysm by the time of re-examination. No normal arterial segment developed an aneurysm that required surgery within 3 years. Conclusion: The development of new aneurysms was common in patients with a PAA; lifelong surveillance may be warranted.