An 86-year-old woman was admitted for a ruptured popliteal artery aneurysm (rPAA, 26 × 28 mm). Due to the patient’s age and comorbidities, emergency endovascular repair was performed. After the failed antegrade guidewire crossing, a retrograde approach from the anterior tibial artery and snaring was performed for lesion crossing, and stentgraft (5 × 50 mm) was deployed from antegrade fashion. At the 14-month follow-up, computed tomography angiogram demonstrated stentgraft patency and reduced aneurysmal size. Although open surgery remains the first-line treatment for infected rPAA, our approach adds to the evidence and can be applied to emergency cases or high-risk surgical patients.

1. Hirsch, AT, Haskal, ZJ, Hertzer, NR, Vascular Disease Foundation et al. ACC/AHA 2005 Practice guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients with Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation 2006; 113: e463–e654.
Google Scholar | Crossref | Medline | ISI2. Akman, J, Katsogridakis, E, Antoniou, GA. Ruptured popliteal artery aneurysms. Vascular 2019; 27: 430–447.
Google Scholar | SAGE Journals | ISI3. Cervin, A, Ravn, H, Björck, M. Ruptured popliteal artery aneurysm. Br J Surg 2018; 105: 1753–1758.
Google Scholar | Crossref | Medline4. Safar, HA, Cinà, CS. Ruptured mycotic aneurysm of the popliteal artery. A case report and review of the literature. J Cardiovasc Surg (Torino) 2001; 42: 237–240.
Google Scholar | Medline5. Ghassani, A, Delva, JC, Berard, X, et al. Stent graft exclusion of a ruptured mycotic popliteal pseudoaneurysm complicating sternoclavicular joint infection. Ann Vasc Surg 2012; 26: e13–e15.
Google Scholar | Crossref6. Muir, D, Kulkarni, SR. Successful endovascular repair of a ruptured popliteal artery aneurysm: a case report and literature review. Case Rep Vasc Med 2020; 2020: 8745780.
Google Scholar | Medline7. Kawai, Y, Morimae, H, Matsushita, M. A ruptured popliteal artery aneurysm treated with coil embolization. Ann Vasc Dis 2019; 12: 80–82.
Google Scholar | Crossref | Medline8. Maleckis, K, Deegan, P, Poulson, W, et al. Comparison of femoropopliteal artery stents under axial and radial compression, axial tension, bending, and torsion deformations. J Mech Behav Biomed Mater 2017; 75: 160–168.
Google Scholar | Crossref | Medline9. Li, JS, Sexton, DJ, Mick, N, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis 2000; 30: 633–638.
Google Scholar | Crossref | Medline | ISI10. Bani-Hani, MG, Elnahas, L, Plant, GR, et al. Endovascular management of ruptured infected popliteal artery aneurysm. J Vasc Surg 2012; 55: 532–534.
Google Scholar | Crossref | Medline | ISI