Abstract
An 87-year-old woman, who had previously undergone ligation and bypass surgery for popliteal artery aneurysm (PAA), was referred to our hospital with a huge pulsatile mass in the right lower femoral region. The computed tomography angiography showed a remarkable enlargement of the excluded thrombosed PAA, 70 mm in maximum diameter, in addition to a proximal anastomotic aneurysm. Operation was performed through a medial approach. A large quantity (1250 g) of old thrombus was removed from the thrombosed PAA, followed by interruption of its patent branches, in a bloodless field under a thigh tourniquet. Reconstruction was performed from the superficial femoral to the below-knee popliteal artery with a reversed vein graft. She had an uneventful postoperative course with a patent graft. Careful long-term follow-up is mandatory for expansion of an excluded PAA.
