ABSTRACT
Objective To present and summarize the data concerning the diagnosis and treatment of popliteal aneurysm in our hospital. Methods The data of popliteal aneurysm in our hospital from 1975 to 2004 were reviewed and analyzed. Eleven patients with 11 diseased limbs were treated, including 8 males and 3 females, age from 21 years to 64 years 〔(48.54?13.66) years〕. The combined diseases include syphilis, rheumatic heart disease and chronic obstructire pulmonary disease etc. Ten patients received operations, including endoaneurysmorrhaphy (n=4) and graft bypass after aneurysmal resection (n=6), through posterior approach (n=7) or medial approach (n=3). One patient, combined with advanced syphilis and heart failure, received conservative treatment because of his poor general condition. Results The common clinical manifestations included popliteal pulsating mass, claudication, difficulty in extension of the knee, pain etc. Acute ischemia occurred in 3 limbs. The diameter of popliteal aneurysms varied from 4-13 cm 〔(6.73?2.69) cm〕. There were 3 (27.3) cases of ruptured aneurysms whose diameters were 7 cm, 7 cm and 11 cm respectively. Special examinations included arteriography and Doppler sonography. Pathological results of these patients were pseudoaneurysm (n=3), syphilitic aneurysm (n=3) and atherosclerotic aneurysm (n=4). Two patients were not followed up, and postoperative follow up of the other 8 patients ranged from 18 months to 30 years. In the group of endoaneurysmorrhaphy, postoperative gangrene of the affected limb occurred in one patient, and above-knee amputation was performed. One patient suffered from intermittent claudication in the group of endoaneurysmorrhaphy and of graft bypass respectively. No manifestations of limb ischemia were found in the other 5 patients during the time of follow up. Conclusion General utilization of Doppler sonography in screening high risk patients might be helpful to detect popliteal aneurysm. For symptomatic popliteal aneurysm or asymptomatic popliteal aneurysm with diameter larger than 3 cm, operation is indicated. Asymptomatic popliteal aneurysms no more than 3 cm in diameter could be monitored with care.
ABSTRACT
Objective To review retrospectively our experience of the diagnosis and surgical treatment in patients with abdominal aortic aneurysm(AAA).Methods The diagnosis and surgical treatment in 72 patients 〔62 men, 10 women; mean age (67.5?9.3) years)〕 with AAA from January 1995 to February 2004 were analyzed. Fifty eight patients with infrarenal AAA and 2 patients with suprarenal AAA underwent elective graft replacement operation; 12 patients with ruptured AAA underwent urgent graft replacement operation. Results Fifty eight patients with infrarenal AAA and 2 patients with suprarenal AAA were cured and 2 patients with infrarenal AAA died of multiple organ failure after elective graft replacement operation, the 30 day mortality rate in patients with infrarenal AAA after elective operation was 3.45%. Seven patients were cured and 5 patients died of multiple organ failure after urgent graft replacement operation, the 30 day mortality rate was 41.67%. Conclusion The elective graft replacement operation in patients with AAA is a safe and effective surgical approach under the improvement of surgical technique and management of perioperative period.