POPLITEAL ANEURYSMS - CLINICAL-FEATURES A ND DIAGNOSIS

Purpose: To identify clinical and radiological features allowing an ea rly diagnosis of popliteal aneurysms. Material and methods: History, c linical features and radiological findings of 23 patients with 37 aneu rysms were reviewed. Results: 14 patients presented with a history of a sudden onset of rest pain localised in the calf or foot. Arteriograp hy found popliteal artery occlusion in 12 of them. Amputation was nece ssary in one patient in spite of immediate diagnosis and therapy. In t wo cases embolisation of the tibial vessels caused intermittent claudi cation. In at least 7 patients the underlying disease was not suspecte d until arteriography was performed. In 16/23 patients the presence of thrombus prevented direct visualisation of the aneurysm and there wer e only secondary angiographic signs of the underlying condition. Thus, arteriography may fail to diagnose popliteal aneurysms. In 21/22 case s colour Doppler sonography was quick and accurate in the assessment o f patent and thrombosed aneurysms. Conclusion: In any patient with isc haemic symptoms of the lower extremity a thorough palpation of the pop liteal fossa should be performed. In patients with a prominent poplite al pulse, in pulseless popliteal tumours and in patients arteriographi cally shown to have popliteal artery occlusion, a sonographic study of both popliteal fossae should be performed.