Objectives: To report the results of surgical treatment of popliteal aneurysms with respect to symptoms and aneurysm size.
Design: A retrospective study based on prospectively registered data, in a single vascular unit.
Patients and methods: Forty-nine patients were subjected to 57 operations from May 1974 to June 2000. Patency and limb salvage rates are compared for limbs with and without symptoms of ischaemia, and for small (2 cm or less) and large (> 2 cm) aneurysms. The long-term survival rate was calculated and compared with that of an age and sex-matched population.
Results: The overall 5 year graft patency was 60%. It was 83% for asymptomatic limbs and 49% for limbs with ischaemic symptoms. This difference was significant (p < 0.05). The overall 5 year limb salvage rate was 76%. It was 100% for asymptomatic and 64% for symptomatic limbs and this difference was significant (p < 0.05). Twenty-one of the aneurysms were 2 cm or less in diameter and 85% of these caused symptoms of ischemia. The operative mortality was 4%. The 5-year survival rate was 57% and significantly lower than that of a demographically matched population.
Conclusion: The results of prophylactic operations for popliteal aneurysms on asymptomatic limbs are significantly better than those of operations done on limbs with ischaemic symptoms. The aneurysm size at which to recommend surgery is still not settled.