[Management of popliteal artery pseudoaneurysms as a result of limb trauma and orthopedic surgery or associated with osteochondromas]

Successful Interventional Treatment of a Huge Pseudoaneurysm of the Popliteal Artery Caused by a Percutaneous Balloon Angioplasty Complication: A Case Report

Pseudoaneurysms are among the most serious complications of percutaneous balloon angioplasty. Although pseudoaneurysm rupture rarely happens, when it does, the result can be fatal; thus, early detection and management are crucial. In this report, we disclose the case of a 34-year-old male with end-stage renal disease who presented with a huge symptomatic pseudoaneurysm of the left popliteal artery, following percutaneous balloon angioplasty three months prior. The pseudoaneurysm was successfully excluded using interventional treatment. The patient recovered well, and the follow-up was uneventful, with excellent patency of the covered stent.

Endovascular repair of spontaneous popliteal artery pseudoaneurysm

Popliteal artery pseudoaneurysms are rare and are generally associated with local trauma, such as orthopaedic surgery or expansile bone lesions in the popliteal fossa. The authors describe a case of popliteal artery pseudoaneurysm in a 24-year-old man. A thorough workup revealed no history of trauma, invasive procedures, vasculitis or any other factors that could constitute a probable cause of the pseudoaneurysm. However, as the patient practices running, it is not possible to rule out minor previous trauma that has not been noticed.

Management of a large ruptured popliteal artery aneurysm involving combined deployment of a covered stent graft and evacuation of popliteal fossa hematoma

Popliteal artery aneurysms (PAAs) are the most common of all peripheral aneurysms. However, ruptured PAA is rare, accounting for approximately 2% of PAA presentations. A literature review found only 11 published cases of ruptured PAAs treated with endovascular repair. In this case, a large (6.9 cm in diameter) ruptured PAA was successfully treated with endovascular repair using the GORE VIABAHN (W. L. Gore & Associates, Flagstaff, Ariz) stent graft and had simultaneous evacuation of popliteal fossa hematoma through a medial distal thigh incision. This facilitated more rapid recovery of mobility, reduced pain, and reduced hospital stay and may represent a useful hybrid surgical approach for this rare condition.

Management of Chronic Massive Traumatic Popliteal Artery Pseudoaneurysm: A Case Series With Different Treatment Strategies

Giant traumatic popliteal artery (PA) pseudoaneurysms (PSA) are rare but limb threatening if untreated. Management can be challenging, as no standardized approach exists. This report evaluates our experience with 3 cases treated differently. Treatment is individualized based on patient disease and comorbidities. Endovascular and local patch arterial repair are safe alternatives to graft bypass when feasible.

[Management of traumatic and iatrogenic arterial pseudoaneurysms in a tropical environment]

A false aneurysm or pseudoaneurysm (PA) is the formation of a pulsatile and encapsulated hematoma in communication with the lumen of a perforated artery. Its origin is different but most cases are associated with a traumatic event. Currently, the referenced treatment is endovascular surgery but it is not feasible for the majority of vascular surgeons working in a tropical environment. The aim of this study was to describe the diagnostic and therapeutic aspects of arterial PA (APA) encountered in our institution and to evaluate the place of open surgical technique in their management. This was a 30-month retrospective and descriptive study carried out in our institution (CHU-JRA, Antananarivo, Madagascar). Between 2012 and 2014, ten cases of APA were operated. There were 8 men with an average age of 30 years. The etiologies were accidental trauma (n=6) or iatrogenic vascular injury (n=4). Most patients had a painful and pulsatile swelling (n=8). The presence of a wound scar located on the swelling was observed in 5 patients. The false aneurysms were localized in the radial (n=3), femoral (n=2), brachial (n=2), carotid (n=2) and ulnar (n=1) arteries. The diagnosis was confirmed by ultrasound Doppler in all patients. The treatment was an open surgical procedure and consisted of lateral suture (n=4), resection with direct end-to-end anastomosis (n=1) or using autologous saphenous vein graft (n=2) or ligation (n=3). Postoperative courses and outcomes at last follow-up were uneventful with optimal patency rate.