Materiały źródłowe

• #1 CE Activity | Popliteal Artery Aneurysm | NPs

  https://www.statpearls.com/nursepractitioner/ce/activity/65258

  Popliteal artery aneurysms occur when the diameter of the popliteal artery undergoes focal dilation, exceeding 50% of its normal range, which typically varies from 0.7 to 1.1 cm. Popliteal artery aneurysms manifest as either fusiform (diffuse dilation) or saccular (asymmetrical) dilations and constitute a significant majority, comprising 85% of all peripheral aneurysms. […] This activity provides clinicians with vital knowledge in recognizing and managing popliteal artery aneurysms, highlighting the significance of early intervention to reduce complications and enhance patient outcomes. […] This activity offers clinicians insights into the anatomical progression of the popliteal artery, the pathophysiology, clinical manifestations, and diagnostic approaches for popliteal artery aneurysms, fostering a comprehensive understanding of this vascular pathology.

• #2 Popliteal artery aneurysm | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/popliteal-artery-aneurysm?embed_domain=hackmd.io%2F%40yipuafecsl2jsu8smr5njq%2Fbnjhjgjghjghjghfavicon.icoradiopaedia-icon-144.pngfavicon.icofavicon.icofavicon.ico&lang=gb

  Popliteal artery aneurysms are the most common peripheral arterial aneurysm and the second most common aneurysm after abdominal aortic aneurysms. […] Symptomatic aneurysms are treated. Asymptomatic aneurysms 2 cm in diameter are also considered for elective treatment: […] endovascular insertion of covered stent: flexible soft device (such as ViabahnTM stent graft) has better outcome due to movement at the knee crease; 5 year patency rate for ViabahnTM stent graft is 70%; disadvantages include kinking or fracture of the stent due to excessive movement […] open surgical repair (usually aneurysmorrhaphy and bypass surgery): vein graft typically used; 5 year patency rate of vein graft is also 70%. […] Complications include distal thromboembolism (commonest: occurs in 18-31% of untreated cases), rupture (rare), and pressure effects if large enough.

• #3 Popliteal Artery Aneurysms

  https://vascularinstitute.com/blog/8731/Popliteal-Artery-Aneurysms

  Popliteal artery aneurysm (PAA) is the dilation and thinning of the popliteal artery which can occur at any point in the posterior distal thigh or knee. The ballooning of the artery can occur through a variety of etiologies consider concurrent cardiovascular disease, autoimmune status, or inflammatory state. While not as common as aortic artery aneurysms (AAA), the risk of mortality from PAAs necessitate a familiarity with the correlating clinical signs and symptoms. […] PAA may be treated surgically or conservatively depending on the clinical presentation. Regardless of whether the aneurysm is symptomatic or not, risk factors should be addressed to mitigate worsening of the condition. Patients who may benefit from surgical aneurysmal repair include those who: 1) present with symptoms of acute limb ischemia with aneurysms of any size and 2) those who have aneurysms greater than 2 cm in diameter. For asymptomatic presentations of the disease, regular ultra sound screenings should be planned every 6 to 12 months, with more frequent imaging done in patients with aneurysms greater than 1.7 cm in diameter. […] While a rare complication of PAA (reported in 2-5% in some sources), rupture of the aneurysm may be life-threatening. IF YOU HAVE A POPLITEAL ARTERY ANEURYSM, YOU NEED TO SEE A VASCULAR SURGEON RIGHT AWAY. YOU WILL NEED LIFELONG FOLLOW-UP WITH YOUR VASCULAR SURGEON.

• #4 SVS releases clinical practice guidelines on popliteal artery aneurysms

  https://vascularnews.com/svs-releases-clinical-practice-guidelines-on-popliteal-artery-aneurysms/

  The Society for Vascular Surgery (SVS) has released new clinical practice guidelines to ensure that patients with popliteal artery aneurysms receive appropriate treatment and care. Aneurysms of the popliteal artery are the most common aneurysms outside of the brain and abdominal aorta. […] Most patients with a popliteal aneurysm do not have symptoms at the time they are discovered, however, over 10% will develop symptoms within two years and over 30% will develop related complications within their lifetimes. The most serious complication of popliteal aneurysm involves clot formation with the possibility of limb loss related to lack of blood flow. For this reason, efforts to diagnose and initiate appropriate treatment strategies are paramount. […] These SVS practice guidelines offer recommendations to inform the diagnosis, evaluation, treatment options, and follow-up of patients with popliteal artery aneurysms. Evidence-based recommendations regarding the evaluation of patients with known popliteal aneurysms, as well as size thresholds for repair are included. Specific circumstances under which aneurysms may be considered for repair at a smaller size are also provided. Recommendations for open versus endovascular repair are given for specific patient populations based on life expectancy, as are recommendations for urgent treatment of thrombosed popliteal aneurysms based on the Rutherford acute ischaemia stage at presentation.

• #5 Popliteal Artery Aneurysms – Endovascular Today

  https://evtoday.com/articles/2003-nov/1103_08.html

  There is an increasing role of endovascular therapy for the management of popliteal artery aneurysmal disease. […] Although the standard treatment of popliteal artery aneurysms has been open repair, there are increasing reports in the literature of endovascular management. […] Aneurysm size plays less of a role in the decision to treat popliteal artery aneurysms compared to aneurysms in other locations, such as the abdominal aorta. This is because the major morbidity from popliteal artery aneurysms is due to thromboembolism rather than rupture. Thus, symptomatic aneurysms require repair regardless of size. […] Long-term graft patency rates directly correlate with preoperative ischemic symptoms. […] Due to the low mortality and complication rates of operative repair in contrast to the high morbidity rate when symptoms develop, most surgeons would proceed to repair any popliteal artery aneurysm 2 cm.

• #6 Popliteal artery aneurysm – UpToDate

  https://www.uptodate.com/contents/popliteal-artery-aneurysm

  Popliteal artery aneurysm is often diagnosed because of screening tests or other imaging studies in patients who do not have obvious symptoms of vascular disease. […] When symptoms are present, they are due to a variable degree of lower extremity ischemic symptoms that can include claudication, distal ischemia due to chronic embolization, or acute limb-threatening ischemia due to thrombosis of the aneurysm or acute thromboembolism. […] Patients with symptomatic popliteal artery aneurysms should be referred for vascular evaluation and repair. […] The management of asymptomatic popliteal artery aneurysms depends upon patient comorbidities, the size of the aneurysm, and the presence or absence of arterial thrombus. […] The surgical and endovascular management of popliteal artery aneurysm is discussed separately. […] Popliteal artery aneurysms are true aneurysms involving all layers of the vessel wall (intima, media, adventitia). […] Aneurysm shape may have clinical implications.

• #7 Popliteal Artery Aneurysm (PAA) • Vascular Health PartnersCall

  https://vhp.communitycare.com/services/popliteal-artery-aneurysm-paa/

  Popliteal artery aneurysms occur in the arteries of the legs behind the knee. PAAs usually do not rupture. Instead, a clot forms and blocks blood flow to the lower leg. If this occurs, bypass surgery is necessary for the preservation of the leg. Without immediate surgery, the leg could be lost requiring amputation. […] You can trust the vascular specialists at Vascular Health Partners to help diagnose and treat your popliteal artery aneurysm. If you have any questions or if you would like to schedule an appointment, please call our office at (518) 782-3900. […] Our vascular surgeons treat patients with popliteal artery aneurysms (PAA) in locations across the Capital Region, NY. Contact us at (518) 782-3900 for more information or to schedule an appointment with Dr. Manish Mehta, Dr. Philip Paty, Dr. Zachary Kostun, Dr. Priya Jayakumar or other members of our vascular surgery team.

• #8 Popliteal Artery Aneurysm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430863/

  Popliteal artery aneurysm is usually managed by an interprofessional team of healthcare professionals, including a vascular surgeon, an interventional radiologist, an endocrinologist, an internist, and a critical care specialist. […] The nurse plays a vital role in monitoring and educating patients with a popliteal artery aneurysm. The patient must understand that when they receive a diagnosis of an aneurysm, they should follow up with a vascular surgeon and undergo elective surgery or have an endovascular procedure. More importantly, the patient must stop smoking, manage high blood pressure, and control blood sugars; these are areas where the clinician can enlist the assistance of pharmacists. […] Finally, examining the patient for a popliteal artery aneurysm in the contralateral leg and abdomen is important. All patients with a pulsatile mass behind the knee should be referred to a radiologist for an ultrasound.

• #9 Popliteal Artery Aneurysm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK430863/

  Popliteal artery aneurysm is usually managed by an interprofessional team of healthcare professionals, including a vascular surgeon, an interventional radiologist, an endocrinologist, an internist, and a critical care specialist. […] The nurse plays a vital role in monitoring and educating patients with a popliteal artery aneurysm. The patient must understand that when they receive a diagnosis of an aneurysm, they should follow up with a vascular surgeon and undergo elective surgery or have an endovascular procedure. More importantly, the patient must stop smoking, manage high blood pressure, and control blood sugars; these are areas where the clinician can enlist the assistance of pharmacists. […] All patients with a pulsatile mass behind the knee should be referred to a radiologist for an ultrasound. […] An interprofessional approach to diagnosis and management yields superior outcomes and reduces morbidity.

• #10 Mayo Clinic Health Library – Popliteal artery aneurysm | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20248747

  A popliteal artery aneurysm is an irregular bulge that occurs in the wall of the artery located behind the knee joint. It is a type of lower extremity aneurysm. […] Complications of popliteal artery aneurysm include blood clots. Blood clots can cause a severe lack of blood flow in the lower leg. […] To diagnose popliteal artery aneurysm, a health care professional usually does a physical exam and checks the legs for swelling, tenderness, and changes in skin color or temperature on the lower leg and behind the knee. […] Treatment of popliteal artery aneurysm depends on the size of the aneurysm, the symptoms, and your age and overall health. Treatment may include regular health checkups, medicines, and surgery.

• #11 Popliteal Aneurysm: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.popliteal-aneurysm-care-instructions.zc1769

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

• #12

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zc1769

  A popliteal aneurysm is a bulge in a blood vessel (artery) behind your knee. The bulge occurs in a weak spot in the artery. It may occur in one or both legs. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Call your doctor or nurse advice line now or seek immediate medical care if: You have sudden pain in your leg or foot. Your leg or foot is cool or pale or changes colour. You have tingling or numbness in your foot. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.

• #13 CE Activity | Popliteal Artery Aneurysm | NPs

  https://www.statpearls.com/nursepractitioner/ce/activity/65258

  Implement appropriate treatment strategies based on the size, location, and symptoms of the popliteal artery aneurysm, which may include surveillance, medical management, or surgical intervention. […] Collaborate with primary care providers and other healthcare professionals involved in the long-term management and follow-up of patients with popliteal artery aneurysms, promoting continuity of care and patient support. […] Outline the pharmacologic therapy as it applies to Popliteal Artery Aneurysm.

• #14 CE Activity | Popliteal Artery Aneurysm | Nurses

  https://www.statpearls.com/nurse/ce/activity/103560/?specialty=specialty

  Popliteal artery aneurysms occur when the diameter of the popliteal artery undergoes focal dilation, exceeding 50% of its normal range, which typically varies from 0.7 to 1.1 cm. […] This activity provides clinicians with vital knowledge in recognizing and managing popliteal artery aneurysms, highlighting the significance of early intervention to reduce complications and enhance patient outcomes. […] This activity offers clinicians insights into the anatomical progression of the popliteal artery, the pathophysiology, clinical manifestations, and diagnostic approaches for popliteal artery aneurysms, fostering a comprehensive understanding of this vascular pathology. […] At the conclusion of this activity, the learner will be better able to: […] Implement appropriate treatment strategies based on the size, location, and symptoms of the popliteal artery aneurysm, which may include surveillance, medical management, or surgical intervention. […] Collaborate with primary care providers and other healthcare professionals involved in the long-term management and follow-up of patients with popliteal artery aneurysms, promoting continuity of care and patient support.

• #15 Popliteal Artery Aneurysm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430863/

  An interprofessional approach to diagnosis and management yields superior outcomes and reduces morbidity. […] The prognosis is good for patients with the popliteal artery aneurysm repaired electively; surgery and endovascular procedure outcomes are similar in the short term. However, the long-term outcome of an endovascular procedure on the popliteal artery aneurysm remains unknown. In patients who present with a rupture of a popliteal artery aneurysm, the outcome is usually poor. Limb loss is common. The amputations may be above or below the knee. The only way to reduce these poor outcomes is by examining pulses in all patients on the initial exam.

• #16 Popliteal artery aneurysm | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/popliteal-artery-aneurysm

  A popliteal artery aneurysm is an irregular bulge that occurs in the wall of the artery located behind the knee joint. It is a type of lower extremity aneurysm. […] Complications of popliteal artery aneurysm include blood clots. Blood clots can cause a severe lack of blood flow in the lower leg. […] Treatment of popliteal artery aneurysm depends on: The size of the aneurysm. The symptoms. Your age and overall health. […] Treatment may include: Regular health checkups. You’ll have frequent checkups and ultrasound tests to check the aneurysm, particularly if the aneurysm is small. […] Medicines. Aspirin or another blood thinner is usually prescribed for people with popliteal artery aneurysm. Medicines may need to be given through a vein. Blood pressure and cholesterol medicine may be given if you have symptoms of heart disease.

• #17 Management of Popliteal Artery Aneurysm

  https://www.acc.org/education-and-meetings/patient-case-quizzes/management-of-popliteal-artery-aneurysm

  A 62-year-old male with pertinent past medical history of hypertension, dyslipidemia, type II diabetes mellitus, and peripheral vascular disease (PVD) is seen as a new patient in your clinic. […] Popliteal artery aneurysms (PAA) are the most common peripheral arterial aneurysm after the aortic-iliac segment aneurysms. Indications for repair are based on symptoms of ischemia (thrombosis or embolism), local compression or from rupture (rare). PAA 2 cm in size in asymptomatic patients is also an indication for repair to decrease risk of thrombosis or embolism. […] The gold standard treatment has been open surgical approach, but endovascular approach is increasingly being utilized. […] Our patient has already failed the endovascular approach in the past and has distal run off disease on the attached CTA. Safe endovascular approach needs at least 1 cm of normal artery to obtain adequate stent graft fixation. Based on the above factors and his lower surgical risk, open surgical repair was done in this patient, making answer A the best option. The patient is at risk of developing thrombus in the aneurysm, and, therefore, frequent examination is not the solution. Thrombolytic therapy is only required before surgery, if the patient presents with acute limb ischemia, as it improves one-year patency rates (79 vs. 71%, P = 0.03). […] Studies are very limited and are unable to show if warfarin sodium or antiplatelet agents alone decrease the risk of thrombosis. Therefore, other choices would not be the best answer in this case.

• #18 Popliteal artery aneurysm – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/popliteal-artery-aneurysm/diagnosis-treatment/drc-20528724

  To diagnose popliteal artery aneurysm, a health care professional usually does a physical exam and checks the legs for: […] Our caring team of Mayo Clinic experts can help you with your popliteal artery aneurysm-related health concerns […] Treatment of popliteal artery aneurysm depends on: […] Treatment may include: […] Regular health checkups. You’ll have frequent checkups and ultrasound tests to check the aneurysm, particularly if the aneurysm is small. […] Medicines. Aspirin or another blood thinner is usually prescribed for people with popliteal artery aneurysm. Medicines may need to be given through a vein. Blood pressure and cholesterol medicine may be given if you have symptoms of heart disease. […] Surgery. Open surgery to repair the damaged artery is generally recommended for any sized popliteal artery aneurysm that’s causing symptoms. Surgery is usually done for any popliteal artery aneurysm that’s 0.8 inches (2 centimeters) or larger. Sometimes, a less invasive procedure called endovascular repair may be done. During this treatment, a stent is placed inside the popliteal artery to hold it open.

• #19 Popliteal artery aneurysms | Medicine Today

  https://medicinetoday.com.au/mt/2017/december/regular-series/popliteal-artery-aneurysms

  Open surgical resection of the aneurysm with bypass or interpositioning using either a synthetic or autologous graft has been widely reported with good outcomes. Patency of these grafts is reported to be between 74 and 94% and mortality associated with the procedure is less than 1%. […] Endovascular stenting is a more recent intervention that is associated with very good outcomes in patients who have a popliteal artery aneurysm without thrombosis. In general, the primary and secondary patency rates of popliteal artery endografts have been reported to be between 86 and 91% at two years. Patients who underwent endovascular stenting also had shorter operating times and a shorter hospital stay compared with patients undergoing open surgery, whereas patency rates were similar between the two groups. […] However, open surgical treatment is reliable and has good outcomes, including low mortality. Endovascular (key-hole) repair is also available for selected patients.

• #19 Popliteal artery aneurysms | Medicine Today

  https://medicinetoday.com.au/mt/2017/december/regular-series/popliteal-artery-aneurysms

  Popliteal artery aneurysms are rare but are associated with increased mortality and limb loss once patients become symptomatic. Surgical intervention is considered for medically fit patients with a popliteal artery aneurysm when the artery reaches at least 20 mm in diameter. […] The aim of surgery is to exclude the aneurysm from the circulation while maintaining patency of the arteries supplying the leg and foot. This can be achieved using either open surgery or endovascular (key-hole) surgery to repair the artery. Results of surgical treatment for popliteal artery aneurysms are best when the aneurysm is asymptomatic. Even though some authors recommend surveillance only for small aneurysms, there is a general consensus among surgeons that medically fit patients should be offered intervention if they: have an aneurysm that exceeds 20mm in size; are symptomatic, given the fact that critical limb ischaemia caused by thrombosis carries a high risk of morbidity and mortality. High-risk patients, bed-bound patients and patients with dementia may be treated conservatively, even if they have larger-size aneurysms.

• #20 Peripheral Aneurysm I Ohio State Medical Center

  https://wexnermedical.osu.edu/heart-vascular/vascular-care/peripheral-aneurysm

  Peripheral aneurysms commonly occur in the popliteal artery but may also occur in the femoral or carotid artery. […] Caring for a peripheral aneurysm is one of many offerings for vascular care at Ohio State. […] A peripheral aneurysm requires surgical repair because of the risk of a sudden blockage or a dislodged clot obstructing blood flow. […] If the aneurysm is small and you have no symptoms, your physician will monitor its size to determine when surgery is needed. […] There are generally two types of aneurysm repair surgeries: Endovascular repair makes use of a catheter that guides a stent graft through small incisions in the groin. The graft is inserted into the aneurysm and seals the aneurysm from within. […] Open surgical repair of a peripheral aneurysm may be recommended if the aneurysm anatomy does not allow for endovascular repair. In this procedure, the damaged area is removed and replaced with a graft (tube). […] If a blood clot is blocking the aneurysm, thrombolytic therapy (the use of drugs to dissolve or break up blood clots) may be used before surgery.

• #21 Popliteal Artery Aneurysm – Lupetin & Unatin, LLC

  https://www.pamedmal.com/popliteal-artery-aneurysm/

  Popliteal artery aneurysm occurs when the popliteal artery—the main blood vessel behind the knee—dilates abnormally, weakening its walls. This condition is the most common peripheral artery aneurysm, accounting for 70-85% of all peripheral aneurysms. […] Immediate medical attention is required to prevent irreversible damage. […] If someone experiences any of the symptoms listed above—especially sudden leg pain, numbness, or coldness—they should seek immediate medical attention. Early detection significantly improves the chances of successful treatment and prevents limb loss. […] The standard of care requires physicians to: promptly recognize and diagnose PAA in at-risk patients; monitor small aneurysms closely and intervene if growth exceeds 2 cm or symptoms develop; act immediately if signs of limb ischemia emerge, ensuring urgent vascular surgery; educate high-risk patients about symptoms and the need for ongoing screening. […] Failure to follow these steps can lead to devastating consequences, including avoidable amputations.

• #22 SVS clinical practice guidelines on popliteal artery aneurysms published

  https://vascularspecialistonline.com/svs-publishes-clinical-practice-guidelines-on-popliteal-artery-aneurysms/

  Popliteal artery aneurysms can cause limb loss and therefore early diagnosis, careful follow-up, and timely treatment of this condition are paramount. […] Surgical bypass and endovascular stent-grafting, both have a role in treatment of appropriately selected patients and these interventions can prevent leg amputation. […] The goal of treatment should be to prevent aneurysm complications including amputation, and to allow for a patient’s rapid return to their baseline functional level. These guidelines should greatly aid in the achievement of these goals.

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