Growth and risk factors for expansion of dilated popliteal arteries

Abstract

Objectives: The aims of this study were to investigate the change in maximum diameter of ectatic popliteal arteries during ultrasound surveillance and assess clinical predictors of their expansion.

Methods: Over a ten year period 67 patients with ectasia affecting one (n = 1) or both (n = 66) popliteal arteries entered this surveillance study. Patients were followed for a median of 3.1 years, at a median scan interval of 7.6 months.

Results: Growth of ectatic popliteal arteries was typically slow (<1 mm/yr). Initial artery diameter at entry to the study was not found to be predictive of subsequent growth. Seven patients followed for a median of 2 years had an expansion in popliteal artery diameter to >or=20 mm during follow-up. All of these patients had undergone aneurysm repairs at other arterial sites and none of them had diabetes. These participants also had a significantly higher rate of previous intervention of the contralateral popliteal artery in comparison to those that did not reach the 20 mm threshold (p < 0.001). Growth profiles of arteries that underwent significant expansion during surveillance were frequently characterised by a staccato pattern.

Conclusions: Expansion of ectatic popliteal arteries is typically slow but difficult to predict. Trends observed in this study suggest that patients with extra-popliteal aneurysms, patients with previously treated contralateral popliteal artery ectasia and those who are not diabetics may be more prone to significant expansion. Further studies are required to validate these potential growth predictors.