Purpose: This study summarizes our experience in the management of popliteal aneurysms in 23 limbs (21 patients)
during a 3-year period. The aim being to provide what constitutes our strategy of management and to determine the factors that influence the outcome.
Methods:The data of 21 patients with 23 aneurysms were reviewed. There were 20 males and only one female, age
ranging between 28 and 70 years, 18 aneurysms were atherosclerotic and 5 were arteritic. Patients were classified into group 1, the acutely ischaemic, group II with no evidence of acute ischaemia and group III, the asymptomatic cases. All patients had colour coded duplex assessment, arteriograpgy was done in cases presenting with ischaemia whether acute or chronic. 21 aneurysms were managed by operative repair while only one small asymptomatic aneurysm with no mural thrombus was managed conservatively. Also, one limb was treated by primary amputation because of irreversible ischaemia.
Results: The overall limb salvage rate in this series was 82.6%. All lost limbs belonged to group I i.e. those presenting
with acute ischaemia. There was no hospital mortality and a follow up period ranging from 6 to 18 months brought forth
neither mortality nor complications.
Conclusion: Operative repair is the ideal treatment for all popliteal. aneurysms. Exclusion and bypass, is the
recommended procedure. Resection being particularly indicated when compression symptoms are conspicuous. There is a place to conserve in small asymptomatic aneurysms with no mural thrombi as well as in symptomatic aneurysms in nonthreatened limbs with poor outflow vessels. In the latter situation, ill-advised surgery may end in limb loss. The results of this study also confirm that the outcome is strongly related to the initial presentation, being worse in the acutely ischaemic cases and hence elective repair is recommended.