Objectives: After exclusion of popliteal artery aneurysms (PAAs) through bypass surgery, there is a risk of persistent flow through collaterals and growth of the excluded aneurysmal sac. This study was conducted to evaluate this risk at long-term follow-up. Methods: Sixty-five PAAs treated by proximal and distal ligation and bypass grafting with reversed autologous vein in 52 patients (1998-2010) were retrospectively reviewed. Results: Mean follow-up was 41 months (range, 1-144 months). Five aneurysms showed residual flow (8%). One of these aneurysms had increased in size, 36 months postoperatively. This aneurysm underwent an embolization procedure after which no flow or further enlargement was demonstrated. Conclusion: In this study, the risk of persistent flow in a PAA excluded by proximal and distal ligation and bypass is low. Still, considering this risk and its possible complications, follow-up by duplex ultrasound in all patients until up to more than 10 years postoperatively is recommended.
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