Open repair of a symptomatic popliteal artery aneurysm in a 71-year-old patient: Case report

Introduction: The most frequent site for true peripheral artery aneurysm formation is the popliteal artery (PA). The clinical presentation of popliteal artery aneurysm (PAA) ranges from the finding of an asymptomatic pulsatile popliteal mass on routine physical examination to acute limb-threatening ischaemia. Case presentation: We are presenting a case of a 71-year-old male patient with 100 m claudication interval on the left lower extremity, with a palpable pulsating circular resistance in the left popliteal fossa. Based on CT angiography results, the patient was diagnosed with a proximal popliteal artery aneurysm. A posterior approach was used for the dissection of the aneurysm. The aneurysm was carefully dissected between semi-membranosus and biceps femoris muscles. Vascular cross-clamps were placed above the proximal PAA on the distal superficial femoral artery (DSFA) and below on the popliteal artery between PA1 and PA2 segments. The aneurysm was removed, and surgical revascularisation with end-to-end anastomosis to the DSFA and proximal PA was performed with a 7 mm polyethylene-terephthalate vascular prosthesis. The patient was discharged on the third postoperative day without any complications with patent vascular graft and palpable crural arteries. The patient remains with a patent prosthetic graft 4 months after the surgery without any ultrasonographic signs of stenosis. Conclusion: Up-to-date, open surgical resection remains a gold standard in the treatment of PAA with superior long-term results over endovascular techniques. Nevertheless, new endovascular techniques are becoming more sophisticated, allowing us to use these endovascular modalities as an alternative treatment option in selected patients.