In most cases, excluded popliteal aneurysm remains silent as the lumen is obliterated with a thrombus. However, continued perfusion through geniculate collateral vessels, leading to pressurization of the ligated aneurysm, can become symptomatic. A 95-year-old healthy-looking male who presented with a pressurized symptomatic popliteal artery aneurysm, 2.5 years, following ligation and exclusion bypass grafting. Two feeding collaterals were shown on computed tomography angiogram, and percutaneous endovascular coiling of these vessels was successfully carried out. This report underscores the value of this minimally invasive approach, particularly in fragile patients, with a review of the pertinent literature.