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Popliteal artery aneurysm

Key sources
The following summarized guidelines for the evaluation and management of popliteal artery aneurysm are prepared by our editorial team based on guidelines from the Society for Vascular Surgery (SVS 2022), the European Society for Vascular Surgery (ESVS 2020), and the American Heart Association (AHA/ACC 2006).
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Guidelines

1.Diagnostic investigations

Diagnostic imaging: obtain ultrasound in patients with a palpable popliteal mass to exclude PAA.
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  • Screening for other aneurysms

2.Medical management

Antiplatelet therapy: consider initiating antiplatelet therapy in patients with PAAs.
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3.Surgical interventions

Indications for repair: as per SVS 2022 guidelines, perform PAA repair in patients with an asymptomatic aneurysm ≥ 20 mm in diameter to reduce the risk of thromboembolic complications and limb loss.
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4.Specific circumstances

Patients with acute limb ischemia: as per SVS 2022 guidelines, stratify interventions for thrombotic and/or embolic complications of PAA by the severity of acute limb ischemia at presentation.
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5.Follow-up and surveillance

Follow-up: as per SVS 2022 guidelines, consider obtaining annual monitoring for changes in symptoms, pulse examination, extent of thrombus, patency of the outflow arteries, and aneurysm diameter in patients with an asymptomatic PAA not offered repair.
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