Background: Although popliteal artery aneurysms (PAA) are rare (0.1% of the general population), they are the most common of the peripheral aneurysms. They are associated with concomitant contralateral PAA and abdominal aortic aneurysm (AAA), with a high risk of complications and an elevated morbidity and mortality.
Methods: We performed a retrospective, transversal and retrolective study of a series of cases. We reviewed the clinical records of 11 patients with the diagnosis of PAA at the ABC Medical Center in Mexico City.
Results: All patients were males, and seven (63.63%) had bilateral PAA resulting in a total of 18 aneurysms; 54.54% had concomitant AAA with an association of 71.42% in the cases of bilateral PAA. Primary risk factors were smoking (90.90%) and hypertension 63.60%. Six (33.33%) aneurysms demonstrated acute thrombosis and critical leg ischemia. Eight (44.44%) aneurysms treated electively had a favorable outcome. The six (33.33%) thrombosed aneurysms showed morbidity, amputation and mortality rates of 66.66, 33.33 and 16.66%, respectively. For the other four (22.22%) aneurysms, treatment was deferred. Specific analysis of the thrombosed PAA demonstrated that the two main factors that predicted thrombosis were hypertension (p = 0.029) and bilaterality.
Conclusions: In view of the high morbidity and mortality rates of thrombosed PAA, it is advisable to perform elective surgical treatment in any popliteal aneurysm >2 cm and with the presence of mural thrombus, torsion and, especially, if it is bilateral and the patient is hypertensive.