The Society for Vascular Surgery (SVS) has released new clinical practice guidelines to ensure that patients with popliteal artery aneurysms receive appropriate treatment and care. Aneurysms of the popliteal artery are the most common aneurysms outside of the brain and abdominal aorta.
Most patients with a popliteal aneurysm do not have symptoms at the time they are discovered, however, over 10% will develop symptoms within two years and over 30% will develop related complications within their lifetimes. The most serious complication of popliteal aneurysm involves clot formation with the possibility of limb loss related to lack of blood flow. For this reason, efforts to diagnose and initiate appropriate treatment strategies are paramount.
These SVS practice guidelines offer recommendations to inform the diagnosis, evaluation, treatment options, and follow-up of patients with popliteal artery aneurysms. Evidence-based recommendations regarding the evaluation of patients with known popliteal aneurysms, as well as size thresholds for repair are included. Specific circumstances under which aneurysms may be considered for repair at a smaller size are also provided. Recommendations for open versus endovascular repair are given for specific patient populations based on life expectancy, as are recommendations for urgent treatment of thrombosed popliteal aneurysms based on the Rutherford acute ischaemia stage at presentation.
Popliteal artery aneurysms can cause limb loss and therefore early diagnosis, careful follow-up, and timely treatment of this condition are paramount.
“Physical finding of a bounding popliteal pulse or a history of an abdominal aortic aneurysm or a popliteal aneurysm in another limb should lead to an ultrasound of the popliteal artery, a widely available and inexpensive test,” said Alik Farber, MD, of Boston Medical Center, Boston, chair of the SVS Popliteal Guideline Writing Group. “Surgical bypass and endovascular stent-grafting, both have a role in treatment of appropriately selected patients and these interventions can prevent leg amputation,” Farber continued.
Vascular surgeons have been at the forefront of providing care for patients with diseases of the arteries and veins. This clinical practice guideline provides vascular surgeons who treat patients with popliteal aneurysms with much needed guidance. The goal of treatment should be to prevent aneurysm complications including amputation, and to allow for a patient’s rapid return to their baseline functional level. These guidelines should greatly aid in the achievement of these goals.
SOURCE: doi.org/10.1016/j.jvs.2021.04.040
