PETE GARCIA M.D.

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Peripheral arterial aneurysms are abnormal dilations of the peripheral arteries caused by weakening of the arterial wall. About 70% of peripheral arterial aneurysms are popliteal aneurysms; 20% are iliofemoral aneurysms. Aneurysms at these locations frequently accompany abdominal aortic aneurysms, and > 50% are bilateral. Rupture is relatively infrequent, but these aneurysms may lead to thromboembolism. They occur in men much more often than women (> 20:1); mean age at presentation is 65. Aneurysms in arm arteries are relatively rare; they may cause limb ischemia, distal embolism, and stroke.

Risk of rupture of extremity aneurysms is low (< 5% for popliteal and 1 to 14% for iliofemoral aneurysms). For leg artery aneurysms, surgical repair is therefore often elective. It is indicated when the arteries are twice normal size or when the patient is symptomatic. However, surgical repair is indicated for all arm artery aneurysms because serious complications are a greater risk. Limb salvage rate after surgical repair is 90 to 98% for asymptomatic patients and 70 to 80% for symptomatic patients.

TRADITIONAL OPEN REPAIR - the affected segment of artery is excised and replaced with a graft.

ENDOVASCULAR STENT GRAFTING - a stent graft (a fabric tube supported by metal wire stents that reinforces the weak spot in the vessel) is inserted into the aneurysm through small incisions in the groin. Endovascular repair of aneurysms does not require a large incision and has a substantially shorter recovery than the conventional open surgical approach.