Two third of popliteal aneurysms are bilateral. One third of these cases may be seen to accompany aortic aneurysm. Almost all popliteal aneurysms are atherosclerotic. It usually involves upper two third of the artery. It usually occurs in men in sixth and seventh decades of life, half of whom are hypertensives. It is frequently symptomless and may be self limiting.
Popiletal aneurysms are two types-
1. Saccular form- may rapidly expand and rupture.
2. Fusiform type- which is often bilateral, rarely rupture and may be complicated by distal embolism.
This aneurysm itself presents as swelling behind the knee. Local pain, tenderness and swelling of the leg is there. Sometimes this aneurysm presents with one of its complications, for example, ischemic ulceration of toes due to emboli, sudden onset of severe ischemia following thrombosis or pain and hematoma formation due to rupture.
Operation is almost always justified because of its complications of thrombosis, embolisation, gangrene and rupture. Only small asymptomatic aneurysms in the elderly patients and thrombosed aneurysms can be left alone.
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