Screening for popliteal aneurysms should not be a routine part of a community-based aneurysm screening program

Martin Claridge¹, Simon Hobbs¹, Clive Quick², Donald Adam¹, Andrew Bradbury¹, Teun Wilmink¹

¹University Department of Vascular Surgery, Birmingham Heartlands Hospital, Birmingham, UK; ²Department of Surgery, Hinchingbrooke Hospital, Huntingdon, UK

Introduction: Several studies have found an increased incidence of peripheral aneurysms in patients with an abdominal aortic aneurysm (AAA). The aim of this study was to determine whether screening for popliteal aneurysms should be part of an AAA screening programme.

Setting: A community-based AAA screening programme

Methods: The diameters of the internal abdominal aorta and both popliteal arteries were assessed by B-Mode ultrasound in a subgroup of the screened population. An AAA was defined as an infrarenal aortic diameter >29 mm. A popliteal aneurysm was defined as a popliteal diameter >19 mm.

Results: Information was available for 283 subjects, 112 subjects with a small AAA, and 171 subjects with a normal aorta. No popliteal aneurysms were found in the subjects with a normal aorta. Three popliteal aneurysms were found in patients with a small AAA. Scanning both popliteal arteries took an experienced sonographer on average three times as long as scanning for an AAA (5 vs 15 minutes).

Conclusion: Popliteal artery aneurysms are seen in less than 3% of men with a small AAA and not at all in men with a normal aortic diameter. It is therefore not cost effective to include screening for popliteal aneurysms in population screening for AAA.

Keywords: popliteal aneurysm, screening program