Aneurysms, Femoral and Popliteal
Femoral and popliteal aneurysms result from progressive atherosclerotic changes occurring in the walls (medial layer) of the major peripheral arteries. Aneurysmal formations may be fusiform (spindle shaped) or saccular (pouchlike), with the fusiform type being three times more common than the saccular type. These formations may be single or multiple segmental lesions, in many cases affecting both legs, and may accompany other arterial aneurysms located in the abdominal aorta or iliac arteries.
This condition is most common in men older than age 50. The clinical course is usually progressive, eventually ending in thrombosis, embolization, and gangrene. Elective surgery before complications arise greatly improves the prognosis.
Femoral and popliteal aneurysms are usually secondary to atherosclerosis. Rarely, they result from congenital weakness in the arterial wall. They may also result from trauma (blunt or penetrating), bacterial infection, or peripheral vascular reconstructive surgery (which causes “suture line” aneurysms, whereby a blood clot forms a second lumen, also called false aneurysms).