Popliteal aneurysm

Aneurisms of the popliteal arteries are rare and mainly seen in men older than 65 years of age. They may appear bilateral. Aortoiliac or femoral aneurysms are also common in this group of patients. Matrix metalloproteinase activity, inflammation, formation of free radicals in the arterial wall, and oxidative stress have been connected with the development of aneurysms. Two/thirds of the patients are seen due to acute or chronic limb ischemia, which exhibit a high rate of morbidity. Asymptomatic popliteal aneurysms with a diameter of 2 cm or more should be considered for treatment, especially when they are partially thrombosed. A duplex examination is used for diagnostic work-up. Digital subtraction angiography is the cornerstone of operative planning. Localized aneurysms in the knee region can be approached posteriorly; medial access is preferred especially for larger aneurysms. Saphenous vein grafts are preferable over prosthetic grafts. A patency rate of 85% after 5 years can be expected with vein grafts. Endografts should only be used in highly selected cases or in a clinical trial setting. © Springer Medizin Verlag 2006.