Snapshot quiz 13/36

Published: 10/18/2013

Authors: Travers H and Birch P

An 85-year-old man presented to clinic with a 6-week history of a painless, swollen right leg. He had a pulsatile right thigh. The computed tomography angiogram shows a large right popliteal aneurysm. The options for management are: radiological stenting using a covered stent; and a bypass procedure to exclude the aneurysm. The patient was managed with a bypass procedure from the superficial femoral artery to the below-knee popliteal artery using reversed saphenous vein. The aneurysm was ligated proximally and distally. This aneurysm was deemed unsuitable for radiological stenting owing to the tortuosity of the vessel. The right leg was swollen due to thrombosis of the popliteal vein caused by the pressure effect from the popliteal aneurysm. As this was at least 6 weeks old, the patient did not receive warfarin therapy.