Surgical Considerations of Peripheral Arterial Aneurysms

Peripheral arterial aneurysms are usually caused by arteriosclerosis, trauma, infection, or poststenotic abnormalities. They occur most frequently in the extremities, since the arteriosclerotic forms are commonest and in the great majority of instances are located in the popliteal or femoral region. Least common is the poststenotic type, which usually occurs in the supraclavicular fossa. Despite differences in etiology and location, these aneurysms are frequently associated with complications that lead to arterial insufficiency, gangrene of the involved extremity, and even death.11Treatment usually has been conservative or has consisted of resection without restoration of arterial continuity. Conservative therapy has been associated with subsequent complications in 50% of patients followed from three to five years, and, although excision without arterial reconstruction has provided significant improvement in the treatment of these lesions, many patients continue to have symptoms of arterial insufficiency.11Recent developments in arterial replacements for segmental arterial lesions have