Which of the following statements about management of popliteal artery aneurysms is/are correct?

A. All symptomatic aneurysms should be treated with surgery.

 C. Thrombolytic therapy may be useful when there is thrombosis of the aneurysm and the distal runoff vessels.

D. The results for surgery for asymptomatic aneurysms are better than those for symptomatic ones.

DISCUSSION: It is generally felt that all symptomatic popliteal aneurysms should be treated with surgery. Treatment of asymptomatic aneurysms is more controversial; some advocate repair of all of these as well. A reasonable approach is to consider surgery for asymptomatic aneurysms larger than 2 cm. Aneurysm ligation with bypass is the most commonly performed operation for popliteal aneurysm, excision being reserved for aneurysms that cause local compressive symptoms. Thrombolytic therapy, given either before or during operation, is useful in clearing the tibial and pedal vessels in cases of acute thrombosis. The patency and limb salvage rates are better for asymptomatic lesions than for symptomatic ones. Autogenous vein is superior to prosthetic material and is the conduit of choice for ligation and bypass of popliteal aneurysms.