Endograft connector technique to treat popliteal artery aneurysm in a morbid obese patient

Surgical repair of popliteal artery aneurysm in morbid obese patients poses additional challenges. We report a morbid obese patient who had a 59 mm right popliteal artery aneurysm which was successfully treated with the endograft connector technique. This technique was used to perform the distal anastomosis of the below-knee femoro-popliteal bypass. A 10 mm Dacron graft was used as a main graft bypass and an 11 mm/10 cm stentgraft as endograft connector. Following the respective tunnel of the Dacron graft, an end-to-side proximal anastomosis was performed at distal femoral artery. The aneurysm exclusion was obtained through a proximal and a distal ligation. Postoperative duplex showed adequate bypass patency. Knee x-rays demonstrated no signs of stent kinking/fractures. The postoperative course was uneventful and the patient was discharged home on fourth day post operative. The six-month computed tomography scan and the 12-month duplex control showed a patent bypass with no signs of stenosis.

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Rupture Of A Popliteal Artery Aneurysm 10 Years After Surgical Repair

Vascular ◽

10.2310/6670.2006.00041 ◽

2006 ◽

Vol 14 (4) ◽

pp. 227-230 ◽

Cited By ~ 9

Author(s):

Hjalmar C. van Santvoort ◽

Jean-Paul P.M. de Vries ◽

Rob van de Mortel ◽

Jan Wille ◽

Eric D.W.M. van de Pavoordt

Keyword(s):

Popliteal Artery ◽

Posterior Approach ◽

Surgical Repair ◽

Artery Aneurysm ◽

Usual Method ◽

Ruptured Aneurysm ◽

Bypass Grafting ◽

Medial Approach ◽

Popliteal Artery Aneurysm ◽

Advantages And Disadvantages

The usual method for popliteal artery aneurysm exclusion is distal and proximal ligation followed by bypass grafting via a medial approach. This technique preserves collaterals to the aneurysm, which might cause back-bleeding and symptomatic enlargement. We report the eighth case in the literature of a ruptured popliteal artery aneurysm after previous ligation and bypass grafting. The ruptured aneurysm was successfully excluded via a posterior approach. The advantage of this approach over the medial approach is the possibility of opening the aneurysm sac to oversew patent side branches, thereby excluding back-bleeding. We review the advantages and disadvantages of both the medial and the dorsal technique to treat popliteal aneurysms.

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Long-term Results of Surgical Repair of Popliteal Artery Aneurysm

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2007.06.019 ◽

2007 ◽

Vol 34 (6) ◽

pp. 714-718 ◽

Cited By ~ 42

Author(s):

R.S.M. Davies ◽

M. Wall ◽

S. Rai ◽

M.H. Simms ◽

R.K. Vohra ◽

...

Keyword(s):

Popliteal Artery ◽

Surgical Repair ◽

Artery Aneurysm ◽

Long Term Results ◽

Popliteal Artery Aneurysm

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Endovascular Repair of Popliteal Artery Aneurysm: A Comparison of Outcomes with Contemporary Open Surgical Repair

Journal of Vascular Surgery ◽

10.1016/j.jvs.2013.08.057 ◽

2013 ◽

Vol 58 (5) ◽

pp. 1431

Author(s):

Ying Huang ◽

Peter Gloviczki ◽

Gustavo S. Oderich ◽

Audra A. Duncan ◽

Manju Kalra ◽

...

Keyword(s):

Endovascular Repair ◽

Popliteal Artery ◽

Surgical Repair ◽

Artery Aneurysm ◽

Open Surgical Repair ◽

Popliteal Artery Aneurysm

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Successful surgical management of a ruptured popliteal artery aneurysm with acute common peroneal nerve neuropathy: A rare case

Vascular ◽

10.1177/1708538120950870 ◽

2020 ◽

pp. 170853812095087

Author(s):

Tiehao Wang ◽

Jichun Zhao ◽

Ding Yuan

Keyword(s):

Popliteal Artery ◽

Peroneal Nerve ◽

Surgical Repair ◽

Surgical Techniques ◽

Artery Aneurysm ◽

Common Peroneal Nerve ◽

Glucocorticoid Therapy ◽

Foot Drop ◽

Open Surgical Repair ◽

Popliteal Artery Aneurysm

Objectives Ruptured popliteal artery aneurysm is a rare entity, which can cause severe nerve neuropathy. Open surgical repair is the preferred treatment for ruptured popliteal artery aneurysm but may aggravate nerve injuries or lead to postoperative aneurysm enlargement. The current surgical techniques for ruptured popliteal artery aneurysm have some deficiencies. Methods We present the case of a 78-year-old woman with sudden swelling of left knee joint and left foot drop, which was caused by the ruptured popliteal artery aneurysm and its compression. A modified open surgical repair was applied in our case, and glucocorticoid therapy was given perioperatively. Results The motor function of left lower limb had rapidly recovered after operation, and six-month follow-up showed patency of prosthetic vessel and significant shrinkage of aneurysm sac. Conclusions Our modified open surgical repair can relieve the compression and prevent possible “type II endoleak” without dissecting in popliteal fossa. Acute common peroneal nerve neuropathy and foot drop are reversible with immediate removal of compression and glucocorticoid therapy for patients with ruptured popliteal artery aneurysm.

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