Overview
A popliteal artery aneurysm is a type of lower extremity aneurysm that occurs in the wall of the artery located behind the knee joint. It is characterized by an irregular bulge in the arterial wall. Popliteal artery aneurysms may not cause noticeable symptoms, but the first symptom could be pain in the lower leg that occurs with walking (claudication). Other signs and symptoms may include knee pain, lower leg pain, swelling behind the knee, and a pulsing sensation behind the knee. The weakening of the artery wall and clogged arteries due to atherosclerosis are common causes of popliteal artery aneurysms. Popliteal artery aneurysms are more common in men than in women and often occur in men with abdominal aortic aneurysm (AAA).
Understanding the disease
Symptoms
Symptoms of a popliteal artery aneurysm may include knee pain, lower leg pain, swelling behind the knee, and a pulsing sensation behind the knee, but they may not always cause noticeable symptoms. The first symptom may be pain in the lower leg that occurs with walking (claudication).
Risk Factors
The risk factors for developing popliteal artery aneurysm include: increasing age, hypertension, smoking, narrowing of a heart valve, history of three or more aneurysms, and a family history of aortic aneurysms. Popliteal artery aneurysms are also more common in men than in women, and often occur in men with abdominal aortic aneurysm.
Development
Popliteal artery aneurysms develop due to a weak spot in the artery wall, which causes it to balloon out. The weakening of the artery wall can be caused by various factors, such as clogged arteries (atherosclerosis), high blood pressure, and wear and tear of the artery due to repetitive use of the knee joint. These aneurysms are more common in men than in women and can lead to complications like blood clots and, in rare cases, rupture. Symptoms may include knee or lower leg pain, swelling behind the knee, and a pulsing sensation.
Assessment and Diagnosis
Triage
If you suspect a popliteal artery aneurysm, it is important to consult a healthcare provider as soon as possible. Popliteal artery aneurysms can lead to complications such as blood clots and, in rare cases, rupture of the aneurysm. Symptoms may include knee pain, lower leg pain, swelling behind the knee, and a pulsing sensation behind the knee. If you experience these symptoms or any other concerning signs, seek medical attention promptly to determine the severity of the aneurysm and receive appropriate treatment.
Diagnosis
To diagnose popliteal artery aneurysm, a health care provider will typically conduct a physical exam to check for any signs of swelling, tenderness, or changes in skin color or temperature behind the knee. They may also inquire about your medical history and health habits, such as smoking. Imaging tests like duplex ultrasound, CT angiography, or magnetic resonance (MR) angiography can help confirm a diagnosis. These tests provide detailed images of blood flow in the arteries and help determine the size and severity of the aneurysm.
Management and Treatment
Complications
Complications of popliteal artery aneurysm may include blood clots (thrombosis) and, in rare cases, rupture of the aneurysm. Thrombosis of a popliteal artery aneurysm can cause a severe lack of blood flow (ischemia) in the lower leg, potentially resulting in the loss of the limb. Additionally, sudden leg ischemia can lead to the following signs and symptoms: severe pain in the lower leg, calf or foot, discoloration of the affected limb, and difficulty moving the affected limb or toes.
Treatment
The treatments for popliteal artery aneurysm may vary depending on the size, location, and growth rate of the aneurysm, as well as the patient's overall health and specific risk factors. Some possible treatment options include:
- Observation: If the aneurysm is small and not causing any symptoms, your healthcare provider may recommend regular check-ups to monitor its size and ensure it doesn't grow or cause complications.
- Lifestyle modifications: Making lifestyle changes such as quitting smoking, controlling high blood pressure, and managing diabetes can help slow the progression of an aneurysm and reduce the risk of complications.
- Medications: Depending on the underlying risk factors, your healthcare provider may prescribe medications to help manage conditions like high blood pressure, high cholesterol, or diabetes.
- Surgical repair: In some cases, surgery may be necessary to repair or replace the affected artery. This can involve open surgery or minimally invasive endovascular techniques, such as stenting or aneurysm repair using a graft.
- Embolization: In cases where the aneurysm is causing significant symptoms or is at risk of rupture, your healthcare provider may recommend embolization, a minimally invasive procedure that involves blocking the blood flow to the aneurysm to prevent further growth or complications. It is essential to consult with a healthcare professional to determine the most appropriate treatment plan for your specific case.