A Case of Ruptured Popliteal Artery Aneurysm with Spontaneous Autoamputation of the Digits due to Untreated Distal Embolism

Abstract

Popliteal artery aneurysms may often rupture and are usually diagnosed based on imaging or other studies performed in patients with suspected or definitive evidence of thromboembolism. However, a ruptured popliteal artery aneurysm and concomitant thromboembolism that leads to spontaneous autoamputation of the digits are rare. Surgical repair is recommended in all patients with popliteal artery aneurysms ; however, guidelines are unclear regarding the exact surgical procedure. Therefore, individualized surgical treatment is necessary. A rare case of popliteal artery aneurysm is reported. The patient was an 87-year-old woman who was referred to our institute in a state of shock. The initial physical examination showed swelling of her right femur and autoamputation of the digits. Enhanced computed tomography showed a ruptured right popliteal aneurysm. A ruptured popliteal artery aneurysm causing thromboembolism was diagnosed. The patient underwent bypass surgery from the superficial femoral artery to the below-knee popliteal artery using a reversed great saphenous vein bypass graft by the medial approach. Subsequently, toe debridement was also performed. Her postoperative course was uneventful, and additional amputation was not required.