Rupture of a popliteal artery aneurysm 10 years after surgical repair.

The usual method for popliteal artery aneurysm exclusion is distal and proximal ligation followed by bypass grafting via a medial approach. This technique preserves collaterals to the aneurysm, which might cause back-bleeding and symptomatic enlargement. We report the eighth case in the literature of a ruptured popliteal artery aneurysm after previous ligation and bypass grafting. The ruptured aneurysm was successfully excluded via a posterior approach. The advantage of this approach over the medial approach is the possibility of opening the aneurysm sac to oversew patent side branches, thereby excluding back-bleeding. We review the advantages and disadvantages of both the medial and the dorsal technique to treat popliteal aneurysms.