Popliteal aneurysm repair can be carried out either via open surgery, as described on this page, or using a keyhole surgery (minimally invasive) and the use of stent grafts.
The preferred procedure to treat popliteal aneurysms is open surgery, although keyhole surgery may be an option for patients who have medical conditions that mean they cannot undergo open surgery. The location and nature of the aneurysm may also determine whether keyhole surgery is possible, and Dr Hagley will be able to advise on this.
The standard open surgery procedure - also referred to as a 'femoropopliteal bypass' - involves tying off the artery either side of the aneurysm using a process called 'ligation' and then putting in place a bypass so that blood continues to flow to the lower leg. Normally this involves making an incision to the inside of the leg (called a 'medial approach') although it is also possible and sometimes preferable to make an incision to the back of the knee ('posterior approach').
The bypass uses a section of another vein in the leg (this does not cause any problems for blood flow back to the heart since the blood simply routes through the remaining veins) or occasionally, where there is not a suitable vein to use, a synthetic bypass, generally a PTFE (polytetrafluroethylene) graft is used instead.
The operation is carried out in the operating theatre and can be under general anaesthetic or regional (spinal or epidural) anaesthetic, where you stay awake during the procedure, which generally takes 2-3 hours.
Patients may need to stay in the intensive care unit for around 24 hours and then a further 5 days in hospital or sometimes slightly longer. Complete recovery from the procedure normally takes around one month.
Preparing for surgery
It is important that you tell us what medications you are taking, including any supplements or alternative treatments. If you smoke you should stop smoking, either completely, or at least four weeks before the procedure. You may need to stop using any anticoagulants or blood thinner and this will be discussed with Dr Hagley.
After surgery it is important to get out of bed and walk around a little. During the recovery period, you will need to wear graduated compression stockings and will need to take both pain killing medication and anticoagulants.
After returning home you will need to come back in for a review consultation two weeks later and during this time you will have some restrictions, such as not being able to drive.