A 70-year-old man is found to have a 3 cm popliteal artery aneurysm on duplex screening. He is asymptomatic with intact distal pulses. What is the most common mode of presentation of popliteal artery aneurysms overall?
- A Rupture with haemorrhagic shock
- B Compression of the common peroneal nerve causing foot drop
- C Acute limb ischaemia from thrombosis or distal embolisation ✓
- D Deep vein thrombosis from venous compression
Correct answer: C. Acute limb ischaemia from thrombosis or distal embolisation
Explanation
Popliteal artery aneurysm is the commonest peripheral artery aneurysm, and about half present with complications rather than as an asymptomatic pulsatile mass, the leading one being acute limb ischaemia from mural thrombosis or embolisation into tibial vessels. Rupture is distinctly uncommon, unlike aortic aneurysms. Nerve and venous compression occur but are far less frequent. Around half are bilateral and many coexist with an abdominal aortic aneurysm, which should be screened for.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
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