Endovascular therapy for a ruptured popliteal aneurysm

Abstract

We here present a case of a ruptured giant popliteal artery aneurysm (PAA) successfully treated with endovascular surgery. A 88-year-old male presented with left limb massive swelling and pain. His general status was critical with acute respiratory insufficiency. CT scan showed massive haematoma in the thigh and a PAA of 9.1 cm in diameter. Urgent endovascular repair was successfully performed under local anaesthesia. Nevertheless, patient died, on second postoperatory day, because of respiratory failure. Up to 50% of PAA present with acute limb ischaemia is due to thrombosis or distal embolization. Rupture is an uncommon complication affecting less than 3% of PAA. Diameter greater than 2 cm or mural thrombosis are indications for elective intervention. Open surgical repair is the first treatment option. In selected patients, endovascular repair can be performed. Midterm results of this technique, recently reported, are comparable to open repair.