Popliteal aneurysm

Approach

  • Expose legs from groin to toes
  1. Inspection
  2. Palpation
    • Femoral pulses, compare sides
    • Comment whether pulses are absent or present, character of pulse
    • Move to popliteal pulses
    • Pulsating mass does not alter with change of position of knee
    • Ankle and foot pulses may not be palpable
  3. Percussion
  4. Ausculation

Completion

  1. Examine the rest of the limb and the other limb for signs of peripheral vascular disease
  2. Examine the abdomen - 50% will have concurrent AAA

Presentation of  popliteal aneursym

  1. From aneursym
    • Lump behind knee
  2. Effects
    • Distal limb ischaemia
    • Acutely ischaemic leg
    • 10% rupture
  3. Screening / incidental

Indications for sugery

  1. Symptomatic
  2. contains thrombi
  3. > 1.8cm

Surgically repaired by excision bypas (popliteal artery ligated above and below the diseased segement and interpositional graft, or simple resection and anastamosis without use of graft)