Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202400212
Jornal Vascular Brasileiro
Case Report

Popliteal artery pseudoaneurysm of spontaneous occurrence: a case report

Pseudoaneurisma de artéria poplítea espontâneo: um relato de caso

Wallace Klein Schwengber; Claudia Carolina Schnorr; Guilherme Camargo Winckler; Ricardo Bocchese Paganella; Marco Aurélio Grudtner

http://dx.doi.org/10.1590/1677-5449.202400212 J Vasc Bras, vol.23, e20240021, 2024
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Abstract

Idiopathic popliteal artery pseudoaneurysms are exceedingly rare, posing significant diagnostic challenges due to their elusive etiology. This report presents the case of a 78-year-old female with no history of trauma or orthopedic procedures who was diagnosed with a large pulsatile mass in the right popliteal fossa. Arteriography confirmed a popliteal artery pseudoaneurysm. Despite extensive clinical evaluation, no causative factors were identified, suggesting an idiopathic diagnosis. The patient underwent open surgical repair using a posterior approach, during which the popliteal artery defect was closed using a bovine pericardium patch. Postoperative follow-up revealed proximal patch stenosis, necessitating angioplasty. This case underscores the need for comprehensive diagnostic evaluation of atypical pseudoaneurysm presentations and highlights the complexities involved in managing idiopathic cases, emphasizing the importance of postoperative follow-up to address potential complications.

Keywords

pseudoaneurysm; popliteal artery; idiopathic

Resumo

Pseudoaneurismas idiopáticos da artéria poplítea são extremamente raros, apresentando desafios diagnósticos significativos devido à sua etiologia desconhecida. Este relato apresenta uma paciente de 78 anos, sem histórico de trauma ou procedimentos ortopédicos, diagnosticada com uma grande massa pulsátil na fossa poplítea direita. A arteriografia confirmou um pseudoaneurisma da artéria poplítea. Apesar de uma avaliação clínica extensa, nenhum fator causal foi identificado, levando ao diagnóstico idiopático. A paciente foi submetida a reparo cirúrgico aberto usando uma abordagem posterior, e o defeito da artéria poplítea foi fechado com um remendo de pericárdio bovino. O acompanhamento pós-operatório revelou estenose proximal do remendo, necessitando de angioplastia. Este caso evidencia a necessidade de avaliações diagnósticas abrangentes em apresentações atípicas de pseudoaneurisma e destaca as complexidades do manejo de casos idiopáticos, enfatizando a importância do acompanhamento pós-operatório para abordar complicações potenciais.

Palavras-chave

pseudoaneurisma; artéria poplítea; idiopático

References

1 Khalifeh A, Kantar R, Watson JDB, Cox S, Sarkar R, Toursvadakohi S. Management of chronic massive traumatic popliteal artery pseudoaneurysm: a case series with different treatment strategies. Vasc Endovascular Surg. 2018;52(1):75-9. http://doi.org/10.1177/1538574417739748. PMid:29130855.

2 Raherinantenaina F, Rajaonanahary TMA, Rakoto Ratsimba HN. Management of popliteal artery pseudoaneurysms as a result of limb trauma and orthopedic surgery or associated with osteochondromas. Ann Cardiol Angeiol. 2016;65(4):265-74. http://doi.org/10.1016/j.ancard.2016.04.023. PMid:27236866.

3 Ammori MB, Evans AR, Mclain AD. Popliteal artery pseudoaneurysm after total knee arthroplasty. J Arthroplasty. 2016;31(9):2004-7. http://doi.org/10.1016/j.arth.2016.02.041. PMid:27021701.

4 Shin Y-S, Hwang Y-G, Savale AP, Han S-B. Popliteal artery pseudoaneurysm following primary total knee arthroplasty. Knee Surg Relat Res. 2014;26(2):117-20. http://doi.org/10.5792/ksrr.2014.26.2.117. PMid:24944978.

5 Takahashi A, Uchida T, Hamasaki A, et al. Popliteal artery pseudoaneurysm associated with osteochondroma. Ann Vasc Dis. 2017;10(3):257-60. http://doi.org/10.3400/avd.cr.17-00026. PMid:29147156.

6 Oliveira GP, Guillaumon AT, Brito IB, Lima JMT, Benvindo SC, Santos LG. Idiopathic popliteal artery pseudoaneurysm: emergency diagnosis and treatment. J Vasc Bras. 2014;13(3):244-8. http://doi.org/10.1590/jvb.2014.032.

7 Miyamotto M, Moreira RCR, Erzinger FL, et al. Pseudo-aneurisma idiopático da artéria poplítea. J Vasc Bras. 2004;3:169-71.

8 Belczak SQ, Góes LG, Stefaniak V. Endovascular repair of spontaneous popliteal artery pseudoaneurysm. BMJ Case Rep. 2020;13(2):e231200. http://doi.org/10.1136/bcr-2019-231200. PMid:32111705.

9 Megalopoulos A, Siminas S, Trelopoulos G. Traumatic pseudoaneurysm of the popliteal artery after blunt trauma: case report and a review of the literature. Vasc Endovascular Surg. 2006;40(6):499-504. http://doi.org/10.1177/1538574406290037. PMid:17202099.

10 Koksoy C, Gyedu A, Alacayir I, Bengisun U, Uncu H, Anadol E. Surgical treatment of peripheral aneurysms in patients with Behcet’s disease. Eur J Vasc Endovasc Surg. 2011;42(4):525-30. http://doi.org/10.1016/j.ejvs.2011.05.010. PMid:21641238.

11 Kim YJ, Baek WK, Kim JY, et al. Pseudoaneurysm of the popliteal artery mimicking tumorous condition. J Korean Surg Soc. 2011;80(Suppl 1):S71-4. http://doi.org/10.4174/jkss.2011.80.Suppl1.S71. PMid:22066090.

12 Dorweiler B, Neufang A, Schmiedt W, et al. Surgical and endovascular treatment options of popliteal artery pseudoaneurysms. J Vasc Surg. 2009;50:1432-8.
 

Submitted date:
02/28/2024

Accepted date:
04/23/2024

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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