Lyubomir Ts. Beshev, Angel P. Marinov, Tihomir V. Andreev, Nachko I. Totzev, Valentin Ch. Velikov, Tsvetomir G. Georgiev, Angel S. Grigorov, Boris D. Tsankov and Borislav A. Ignatov
Clinical manifestations, possibilities for accurate diagnosis of popliteal aneurysms, and operative approaches applied depending on their location are presented, as well as results from treatment over a four-year period. Popliteal artery aneurysms accounted for 5.63% of all 266 cases of acute arterial insufficiency. The mean age of the patients was 68.8 years, and the male:female ratio – 4:1. In five patients (33.33%), the localization of aneurysm was unilateral. In 80% of the cases with bilateral popliteal aneurysms, the aneurysms were combined with aneurysms of other locations. The surgical technique applied was posterior approach with resection of the aneurysm and interposition of a polytetrafluoroethylene (PTFE) prosthesis. The early patency rate of the reconstructed segment was 100%. Late patency rate of the reconstructed segment was 90.9%. Despite the better late results in femoropopliteal reconstruction, we think that a posterior approach with prosthesis implantation is better because it saves the great saphenous vein. The presence of multiple aneurysms in the patients studied (80%) determined the low survival at 5 and 10 years, which makes it comparable to the results from applying the two surgical methods.