Popliteal artery aneurysm (figure 1) presents in a variety of ways. Many patients are asymptomatic, while others have symptoms referable to the aneurysm such as pain with ambulation (claudication) or acute limb ischemia due to aneurysm thrombosis or distal embolization [1-3]. When popliteal aneurysm repair is indicated, an open surgical or endovascular approach can be used. The choice of repair depends upon the clinical presentation, anatomic factors, and patient comorbidities.
The approach to popliteal artery aneurysm repair, perioperative care, complications of repair, and surgical outcomes will be reviewed here. The diagnosis and nonsurgical management of popliteal artery aneurysm are discussed elsewhere. (See "Popliteal artery aneurysm".)
Surgical or endovascular repair for popliteal aneurysms is indicated under the following circumstances:
●Symptomatic (eg acute limb ischemia, disabling claudication) popliteal aneurysm of any size
●Selected asymptomatic popliteal aneurysm (patent) depending upon size and presence of thrombus