Bilateral popliteal aneurysm repair: a case report and literature review

Verónica Rubio-Anaya, Department of Angiology, Vascular and Endovascular Surgery, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico
Mónica S. Ponce-Rivera, ProVascular, Centro de Angiología y Terapia Vascular de Tampico, Tampico, Tamps., Mexico
Alejandro Loera-Barragán, Department of Angiology, Vascular and Endovascular Surgery, Hospital Ángeles, Tampico, Tamps., México
Patricia López-Hernández, ProVascular, Centro de Angiología y Terapia Vascular de Tampico, Tampico, Tamps., Mexico
Jaime G. Estrada-Guerrero, ProVascular, Centro de Angiología y Terapia Vascular de Tampico, Tampico, Tamps., Mexico
Gregorio Arellano-Gutiérrez, Department of Angiology, Vascular and Endovascular Surgery, Hospital General Regional 58, IMSS, León, Gto., Mexico

Popliteal artery aneurysms (PAA) are very rare, affecting approximately 1% of the general population. However, they are the most common peripheral artery aneurysms and frequently coexist with abdominal aortic aneurysms and bilateral involvement in up to 50%. PAAs carry a high risk of thrombosis, embolization and limb loss. We present a 64-year-old male with a 2 weeks history of intermittent, progressive right lower limb pain and claudication. Physical examination revealed a pulsatile mass in the right popliteal fossa. Arterial Doppler ultrasound identified a 45 × 33 × 33 millimeters (mm) dissecting PAA. Follow-up computed tomography angiography identified a contralateral 65 × 40 mm PAA with thrombus. The patient underwent two stages exclusion and bypass of the PAA with bilateral polytetrafluoroethylene grafts. PAAs require vigilant surveillance due to their high risk of complications and frequent association with aneurysms in other anatomic sites. Optimal management remains debated, especially in Latin America. This case highlights the importance of bilateral screening and early intervention to prevent complications, emphasizing the need for standardize management strategies.

Keywords: Popliteal artery aneurysm. Repair. Bilateral. Polytetrafluoroethylene graft.