POPLITEAL ANEURYSM AND LEG ISCHEMIA - SUR GERY FIRST

The treatment of symptomatic popliteal aneurysms is debated should loc al fibrinolysis or surgery first be used first? The authors report the ir experience in the treatment of 90 popliteal aneurysms in 66 patient s. In this series were only examined those aneurysms with either acute ischaemia 12 (27%) or sub-acute ischaemia 21 (45%). The treatment of those cases with acute ischaemia was surgical for all, allowing salvag e in all cases. Sub-acute ischaemia was treated with either: a surgica l bypass with exclusion of the aneurysm in 7 cases, or lumbar sympathe ctomy in 7 cases, or medical treatment in 6 cases or local fibrinolysi s for distal ischaemia in on case only. There was no peri-operative mo rtality, only one amputation was required (5%).