A 62-year-old male patient presented to the emergency department with a cool right foot. On examination, his femoral pulse is intact and a pulsatile mass is appreciated in the popliteal fossa. His right foot is cool but motor and sensory function are intact. No pedal pulses are palpable and faint Doppler signals are audible.

Question 1

The presence of a popliteal artery aneurysm increases a patient’s risk for:

A.  Contralateral popliteal artery aneurysm

B.  Infra-renal abdominal aortic aneurysm

C.  Other peripheral artery aneurysms

D.  All of the above

Question 2

Which of the following is the initial diagnostic test of choice for popliteal artery aneurysm?

A.  Magnetic resonance imaging B.  Contrast arteriography

C.  Duplex ultrasonography

D.  Computed tomography angiography

Duplex ultrasonography demonstrates giant bilateral popliteal artery aneurysms and a 4.5 cm infra-renal abdominal aortic aneurysm. A computed tomography (CT) angiogram is obtained to further evaluate the aortic aneurysm and both lower extremities are included (Fig.8.1).Theright(symptomatic)poplitealarteryaneurysmisresectedthroughaposterior approach with the ipsilateral greater saphenous vein used as an interposition graft. After his recovery from this repair, the same approach is used to repair the contralateral aneurysm.

S. Shin ( )

Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

Fig. 8.1  Computed tomography angiogram demonstrating bilateral giant popliteal artery aneurysms

Question 3

Popliteal aneurysms can present with

A.  Distal embolization

B.  Acute thrombosis

C.  Swelling from venous compression

D.  Asymptomatic

Question 4

Emergent repair of popliteal artery aneurysms results in similar graft patency and limb preservation when compared to elective repair.

A.  True

B.  False

An 82-year-old female patient is referred for evaluation of a right blue second toe. She complains of a painful toe that has been blue for quite some time. On examination, her femoral pulse is intact with a prominent popliteal pulse on the right with thready pedal pulses bilaterally. A duplex ultrasound demonstrates a 2.0 cm popliteal artery aneurysm with 3–4 cm of normal artery proximal and distal to the aneurysm. The left popliteal artery is normal in size without thrombus. A CT angiogram is obtained and confirms a partially thrombosed 2.0 cm popliteal artery aneurysm (Fig. 8.2). The patient has a history of CAD, CHF with a left ventricular ejection fraction of 25%. The right lower extremity angiogram shows the runoff (Fig. 8.3).