A 70-year-old hypertensive man has a pulsatile mass in the right popliteal fossa confirmed as a 3 cm popliteal artery aneurysm containing mural thrombus. Screening ultrasound is planned. Which associated finding is most likely to be detected?

• A A coexisting femoral vein aneurysm on the same side
• B An abdominal aortic aneurysm or a contralateral popliteal aneurysm ✓
• C A bicuspid aortic valve with ascending aortic dilatation
• D An ipsilateral persistent sciatic artery

Explanation

Popliteal aneurysm is the commonest peripheral arterial aneurysm, is degenerative in origin like AAA, and is strongly associated with other aneurysms: roughly half of patients harbour an abdominal aortic aneurysm and the majority have contralateral popliteal disease, so the whole arterial tree should be screened. Its main danger is limb loss from acute thrombosis or distal embolisation of mural thrombus rather than rupture. Persistent sciatic artery is a rare congenital anomaly associated with aneurysmal degeneration but not a routine screening target.

Reference: Rutherford's Vascular Surgery and Endovascular Therapy, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.