Thrombosed popliteal artery aneurysm and limb ischemia

Case contributed by James Harvey


ED presentation with 1 day history of swollen and painful right leg. Poor capillary refill.

Patient Data

Age: 80 years
Gender: Male

There is a large right popliteal artery aneurysm. Thin, linear contrast enhancement is seen within the aneurysmal sac but no flow is seen within the distal popliteal artery.

The right peroneal artery is reconstituted by superficial collateral vessels. Patchy opacification of the anterior tibial artery to the mid calf also reflects collateral flow.

Smaller left popliteal artery aneurysm. Left posterior tibial artery is occluded close to its origin. The anterior tibial artery and peroneal artery opacity normally.

Case Discussion

Aneurysm thrombosis and critical limb ischemia is the most feared complication of a popliteal artery aneurysm. The majority of popliteal aneurysms are bilateral (as in this case).

This patient was started on an IV heparin infusion and transferred to a tertiary hospital where he underwent emergent fem-pop bypass grafting.

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