The atherosclerotic popliteal aneurysm: report of diagnosis and treatment in twenty-six cases.

Twenty-six popliteal aneurysms in eighteen patients are presented. There was a 45 per cent incidence of bilaterality and a 33 per cent incidence of extrapopliteal aneurysms. Rest pain and/or gangrene secondary to thrombosis of the aneurysm were the most common presenting symptoms. Eleven reconstructive procedures were carried out with good results and no mortality. All popliteal aneurysms should be repaired when found regardless of size, and due to the high incidence of extrapopliteal aneurysm, these patients should undergo a thorough search for aneurysms at other sites. They may be excised with end-to-end anastomosis with the graft or simply ligated and bypass grafting accomplished. Saphenous vein or Dacron graft may be used with equally satisfactory results. Long-term follow-up is recommended because of propensity for recurrence of aneurysms in the residual popliteal artery and to rule out extrapopliteal aneurysm formation.