Abstract：
BACKGROUND: Popliteal artery aneurysms (PAA) can be very challenging, especially in cases of very large PAAs, with a minimal number of case reports published in the literature.
METHODS: This is a case report of a 68-year-old male patient with hypertension, hyperlipidemia, diabetes, and schizophrenia who was found to have a giant (10x8x6cm) partially thrombosed PAA, treated with interposition polytetrafluoroethylene (PTFE) graft via a posterior approach.
RESULTS: Under general anesthesia, the patient was placed in a prone position, and an extended lazy \"S\" incision was made on the popliteal fossa. After obtaining proximal and distal exposure, the aneurysm sac was skeletonized, preserving the popliteal vein and the tibial nerve. After proximal and distal control was obtained, the patient was systemically heparinized, and the aneurysm sac was opened. Some genicular branches were ligated inside the aneurysm, and part of the aneurysm sac was excised. A 7 mm PTFE graft was used for reconstruction in an end-to-end fashion. Suction drains were placed in the popliteal space, and the fascia and skin were approximated. The patient was discharged home on the 2nd postoperative day on aspirin and statin with ultrasound surveillance. The patient has remained asymptomatic during follow-up with a patent graft.
CONCLUSIONS: Open surgical repair constitutes the gold standard of care for huge PAAs to prevent distal thromboembolic events and mass pressure effects from the aneurysm. Documentation of additional experience with open repair of huge PAAs would be beneficial and could help clinical decision-making.
METHODS: This is a case report of a 68-year-old male patient with hypertension, hyperlipidemia, diabetes, and schizophrenia who was found to have a giant (10x8x6cm) partially thrombosed PAA, treated with interposition polytetrafluoroethylene (PTFE) graft via a posterior approach.
RESULTS: Under general anesthesia, the patient was placed in a prone position, and an extended lazy \"S\" incision was made on the popliteal fossa. After obtaining proximal and distal exposure, the aneurysm sac was skeletonized, preserving the popliteal vein and the tibial nerve. After proximal and distal control was obtained, the patient was systemically heparinized, and the aneurysm sac was opened. Some genicular branches were ligated inside the aneurysm, and part of the aneurysm sac was excised. A 7 mm PTFE graft was used for reconstruction in an end-to-end fashion. Suction drains were placed in the popliteal space, and the fascia and skin were approximated. The patient was discharged home on the 2nd postoperative day on aspirin and statin with ultrasound surveillance. The patient has remained asymptomatic during follow-up with a patent graft.
CONCLUSIONS: Open surgical repair constitutes the gold standard of care for huge PAAs to prevent distal thromboembolic events and mass pressure effects from the aneurysm. Documentation of additional experience with open repair of huge PAAs would be beneficial and could help clinical decision-making.
摘要：
背景：and动脉动脉瘤（PAA）可能非常具有挑战性，特别是在非常大的PAA的情况下，文献中发表的病例报告数量最少。
方法：这是一例68岁男性高血压患者，高脂血症,糖尿病,和精神分裂症被发现患有巨大（10x8x6cm）部分血栓形成的PAA，通过后路插入聚四氟乙烯（PTFE）移植治疗。
结果：在全身麻醉下，病人处于俯卧位,在pop窝上做了一个延伸的懒惰的“S”切口。在获得近端和远端暴露后，动脉瘤囊被骨骼化，保留the静脉和胫神经。在获得近端和远端控制后，患者全身肝素化,动脉瘤囊打开了.动脉瘤内结扎了一些膝状分支,切除了部分动脉瘤囊。使用7mmPTFE移植物以端到端方式进行重建。抽吸排水管被放置在the空间中，筋膜和皮肤接近。患者在术后第2天在超声监测下使用阿司匹林和他汀类药物出院。患者在移植物通畅的随访期间仍无症状。
结论：开放手术修复是治疗巨大PAA的黄金标准，以预防动脉瘤的远端血栓栓塞事件和质量压力效应。记录开放式修复巨大PAA的额外经验将是有益的，并有助于临床决策。
方法：这是一例68岁男性高血压患者，高脂血症,糖尿病,和精神分裂症被发现患有巨大（10x8x6cm）部分血栓形成的PAA，通过后路插入聚四氟乙烯（PTFE）移植治疗。
结果：在全身麻醉下，病人处于俯卧位,在pop窝上做了一个延伸的懒惰的“S”切口。在获得近端和远端暴露后，动脉瘤囊被骨骼化，保留the静脉和胫神经。在获得近端和远端控制后，患者全身肝素化,动脉瘤囊打开了.动脉瘤内结扎了一些膝状分支,切除了部分动脉瘤囊。使用7mmPTFE移植物以端到端方式进行重建。抽吸排水管被放置在the空间中，筋膜和皮肤接近。患者在术后第2天在超声监测下使用阿司匹林和他汀类药物出院。患者在移植物通畅的随访期间仍无症状。
结论：开放手术修复是治疗巨大PAA的黄金标准，以预防动脉瘤的远端血栓栓塞事件和质量压力效应。记录开放式修复巨大PAA的额外经验将是有益的，并有助于临床决策。
