Sotirios Siminas

Abstract: Angelos Megalopoulos1, Konstantinos Vasiliadis1 Contact Information, Sotirios Siminas2, Panagiotis Givissis3, Efthimia Vargiami4, Dimitrios Zafeiriou4, Dimitrios Botsios1 and Dimitrios Betsis1 (1) Fourth Surgical Department, Aristotle University of Thessaloniki, General Regional Hospital �G. Papanikolaou�, Exohi 570-10, Thessaloniki, Greece (2) First Surgical Department, General Regional Hospital �G. Papanikolaou�, Thessaloniki, Greecec (3) First Orthopedic Department, Aristotle University of Thessaloniki, General Regional Hospital �G. Papanikolaou�, Exohi 570-10, Thessaloniki, Greece (4) First Department of Pediatrics, Aristotle University of Thessaloniki, Neurodevelopmental Department, General Hospital �Hippokratio�, Thessaloniki, Greece (5) Dorileou 3, Kalamaria, 55 133 Thessaloniki, Greece Received: 17 May 2006 Accepted: 03 January 2007 Published online: 27 August 2007 Abstract Pseudoaneurysms of the popliteal artery (PPA) rarely occur in children. In fact, we found only 10 cases reported in the medical literature. We report the case of a 4-year-old boy who presented with a painful palpable mass in the right popliteal fossa. He also had mild, painless right foot-drop and difficulty toe-walking on the same side. The diagnosis of a PPA was based on the findings of triplex ultrasound and computed tomographic-angiography. We attributed the cause of the lesion to blunt trauma, which he had suffered 2 years earlier. Thorough preoperative evaluation excluded the possibility of a self-immune process or a bone tumor in the region. Neurological examination demonstrated a mild, isolated, peripheral mononeuropathy of the right peroneal nerve. Thus, we performed surgical repair using an autologous reversed great saphenous vein graft. The patient had an uneventful postoperative course and his peripheral neuropathy and foot-drop resolved completely within 1 month after surgery. Now, after 3 years of follow-up, the patient has a patent graft and a fully functioning limb. PPAs are rare, especially in children, and trauma is the predominating underlying cause. PPAs should be treated immediately after diagnosis because their complications are associated with high rates of functional impairment and even limb loss.

Abstract: Traumatic pseudoaneurysm of the popliteal artery after blunt trauma: case report and a review of the literature. Megalopoulos A, Siminas S, Trelopoulos G. 1st Surgical Clinic, General Hospital "G. Papanikolaou," Exohi, Thessaloniki, Greece. Abstract Pseudoaneurysms of the popliteal artery following trauma are rare lesions. We present 3 cases of pseudoaneurysms of the popliteal artery (4, 20, and 45 years old respectively) with a delayed presentation, following blunt trauma, presenting over a 3-year period, and a short review of the relevant literature. A delayed pattern of presentation, over 2 years after blunt popliteal trauma, was observed in all patients. They presented with a painful pulsatile mass in the popliteal fossa, and their peripheral pulses were normal. Orthopedic and rheumatologic evaluation findings were negative. Diagnostic evaluation included triplex, arteriography, and computed tomography angiography. A posterior popliteal approach was used, and after aneurysmal excision, reversed great saphenous vein and lesser saphenous vein (1 patient) grafts were used. After 2 to 4 years of follow-up, all grafts remain patent and the patients have fully functional limbs. A literature search revealed 70 cases of pseudoaneurysms of the popliteal artery reported in civilian settings. These lesions should be repaired shortly because their complications (rupture, thromboembolic episodes) carry a high risk for limb dysfunction and amputation. Penetrating or blunt trauma is the main causative factor (62.5%), but iatrogenic trauma accounts for an increasing number of reports (37.5%). Strict follow-up of popliteal trauma is essential. A high level of suspicion and awareness can lead to early diagnosis and treatment of pseudoaneurysms of the popliteal artery and prevent the serious complications associated with these lesions.

Abstract: We report a case of an 85-year-old man with true isolated bilateral superficial femoral artery aneurysms. The aneurysm size was 6.2 cm on the right and 4.8 cm on the left. They were repaired with transfemoral endovascular placement of three excluder stent grafts on the right and two excluder stent grafts on the left. Both procedures were done under local anaesthesia.