Management of a large ruptured popliteal artery aneurysm involving combined deployment of a covered stent graft and evacuation of popliteal fossa hematoma.

Popliteal artery aneurysms (PAAs) are the most common of all peripheral aneurysms. However, ruptured PAA is rare, accounting for approximately 2% of PAA presentations. A literature review found only 11 published cases of ruptured PAAs treated with endovascular repair. In this case, a large (6.9 cm in diameter) ruptured PAA was successfully treated with endovascular repair using the GORE VIABAHN (W. L. Gore & Associates, Flagstaff, Ariz) stent graft and had simultaneous evacuation of popliteal fossa hematoma through a medial distal thigh incision. This facilitated more rapid recovery of mobility, reduced pain, and reduced hospital stay and may represent a useful hybrid surgical approach for this rare condition.