November 27, 2009

Popliteal Artery Aneurysm

Figure 1: Gray-scale ultrasound of the let popliteal ultrasound shows a fusiform aneurysm of the popliteal artery, measuring 2 cm.
Figure 2: Color Doppler US image shows partial thrombosis of the aneurysm.


Facts:
  • Most common peripheral artery aneurysm
  • Most commonly due to atherosclerosis
  • More common in male
  • Commonly bilateral (need to examine the contralateral popliteal artery), and commonly associated with abdominal aortic and iliac artery aneurysm in about half of all cases.
  • Presentation: cold lower extremity from acute thrombosis or distal embolization, asymptomatic pulsatile popliteal fossa mass, rarely rupture
Indication for Repair
  1. Size 2 cm or greater
  2. Intraluminal thrombus

Imaging Strategy
  • Doppler US for diagnosis and follow up
  • MDCT for planning of repair (surgical or endovascular): extent, location of associated peripheral vascular disease, nearby branch vessels, size and angulation of the aneurysm
References
1. Blackbourne LH. Surgical recall, 5th ed, 2008.
2. Funaki B, Lorenz J, Ha TV. Teaching atlas of vascular and non-vascular interventional radiology, 2007.

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