Principles of surgical Principles of surgical management in patients with management in patients with aneurysms of the popliteal aneurysms of the popliteal

artery.artery.

Piotr Niedziela, Andrzej Szczepanowski, Piotr Niedziela, Andrzej Szczepanowski, Paweł Bronikowski, Roman PaduchPaweł Bronikowski, Roman Paduch

Praga 2009

Etiology:Etiology:

atherosclerosis (95%)atherosclerosis (95%)

Marfan syndromeMarfan syndrome

post- traumatic changespost- traumatic changes

60%

40%

Symptoms:Symptoms:

- claudicatio intermitensclaudicatio intermitens

rest painrest pain

pain of limb pain of limb

- blue color of foot skinblue color of foot skin

Consequence of Consequence of asymptomatic asymptomatic

aneurysmaneurysm- acute ischaemia of limbacute ischaemia of limb

thrombosis of popliteal arterythrombosis of popliteal artery

compression of surrounding nerves compression of surrounding nerves

Diagnosis:Diagnosis:

case history case history

physical egzaminationphysical egzamination

Confirmed of diagnosisConfirmed of diagnosis

Ultrasound egzaminationUltrasound egzamination

Arteriography Arteriography

Differental diagnosisDifferental diagnosis

Becker cyst

Neoplastic changes

Two basic typesTwo basic types

LargeLarge SmallSmall

The treatment:The treatment:

- size of aneurysm

shape

location

patency of crural arteries

Stages of treatment:Stages of treatment:

- patency of peripheral vessels patency of peripheral vessels

excision or ligation of aneurysm excision or ligation of aneurysm

- reconstruction of arteries- reconstruction of arteries

Types of Types of reconstruction:reconstruction:

- by- pass veins graftby- pass veins graft

vascular prosthesis vascular prosthesis

1. The patients with aneurisms of popliteal arteries required the specialistic diagnosis and

most often operative treatment.

2. The asymptomatic aneurism of the popliteal artery is an indication of the reconstructive

intervention.

3. The better results were obtained when the operation was conducted according to plan and

when the own vein of a patient was used to reconstruct the blood flow.

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