Popliteal aneurysm-All are true except-
• Occur in conjunction with aortic aneurysm in 40% cases
• Most isolated iliac aneurysm involve common iliac artery (70%) and internal iliac artery (20%)
• Multiple iliac aneurysms occur in most patients and are bilateral in 33% cases
Etiology
• Occur in association with atherosclerosis
• Can also occur in pregnancy in absence of atherosclerosis as well as in Marfan and Ehlers-Danlos syndromes, Kawasaki disease, Takayasu’s arteritis, cystic medial necrosis and arterial dissection
Clinical Features
• More common in males, right and left sides are equally involved
• Symptoms are caused by compression of adjacent pelvic structures (bladder, colon, ureter, rectum, lumbosacral nerves and pelvic vein)
• Most common iliac aneurysms can be palpated on abdominal exam whereas internal iliac artery aneurysm are more readily palpated on rectal examination
Treatment
• Operative mortality rate in patients with ruptured iliac aneurysm is 40%.
• Iliac aneurysms >3.5 cm are repaired if possible.
Minimum Size for Surgery (AIPF: All India Police Force)
Abdominal Aortic Aneurysm (5.5 cm) = Iliac aneurysm (3.5 cm) + Popliteal/Femoral aneurysm (2.0 cm)
Presents as a swelling behind the knee
Presents with symptoms due to complication
Surgery is indicated in case of complication
Uncommon among peripheral aneurysm