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Emergency intervention for thrombosed popliteal artery aneurysm: can the limb be salvaged?

We present a review and our own experience of the demographic aspects of popliteal artery aneurysms (PAAs), their clinical presentation, the treatment alternatives and associated outcome. The incidence of PAA:s varies between 0,1-1%. 95% of the patients are male. 50% are asymptomatic at the time of diagnosis. Annually, 5-24% of PAAs develop symptoms. The clinical presentation varies widely with an amputation rate of up to 78% in acute ischemic cases. The main indication for PAA repair is prevention of embolisation but acute revascularisation is the primary task in the emergency setting. Open surgery and endovascular techniques are described and can be combined with intraarterial thrombolysis as pre- or intraoperative treatment. The literature proves often inconclusive due to small numbers of heterogenous cases. Each case, therefore, needs to be assessed individually and offered the most suitable treatment.