Subjective
Date of visit
Reason for visit (initial evaluation for suspected popliteal artery aneurysm (PAA), follow-up for known PAA)
History of present illness:
Symptoms (may be absent in early stages):
Claudication (aching pain in the calf with activity that improves with rest) – classic symptom
Leg weakness or fatigue
Rest pain (pain even at rest, a sign of more advanced disease)
Coolness or numbness in the leg
Skin changes over the popliteal fossa (redness, ulceration) – very concerning signs
Duration and progression of symptoms
Past medical history (relevant conditions):
Peripheral artery disease (PAD)
Atherosclerosis
Hypertension
Diabetes
Smoking history (major risk factor)
Medications (current medications)
Allergies
Objective
Vital signs (temperature, heart rate, blood pressure) – may be normal unless complications arise
Physical exam:
General (assessing for signs of chronic arterial insufficiency)
Peripheral vascular exam:
Femoral pulses (present or absent)
Popliteal pulse (palpation behind the knee – may be weak or absent in PAA)
Ankle-brachial index (ABI) – ratio of blood pressure in the ankle compared to the arm (low ABI suggests PAD)
Skin examination (looking for discoloration, hair loss, ulceration)
Neurologic exam (assessing for sensation and strength in the leg)
Assessment
Suspected popliteal artery aneurysm based on clinical presentation and physical exam findings
Consideration of alternative diagnoses (deep vein thrombosis, Baker’s cyst)
Severity of PAA (based on symptoms, ABI)
Plan
Diagnostic workup (may include some of the following to confirm PAA and assess severity):
Ultrasound of the popliteal artery
CT angiography (provides detailed images of blood vessels)
Treatment (depends on the severity and symptoms):
Conservative management (lifestyle modifications, smoking cessation, medication for PAD):
Exercise therapy
Smoking cessation counseling
Medications to improve circulation (cilostazol)
Endovascular intervention (minimally invasive procedure):
Balloon angioplasty and stent placement to open the narrowed artery
Open surgical repair (for large or ruptured aneurysms):
Bypass surgery using a graft to reroute blood flow around the aneurysm
Antiplatelet medications (aspirin or clopidogrel) to prevent blood clots
Education
Explain popliteal artery aneurysm, its causes, risk factors, and potential complications (blood clot formation, limb ischemia).
Discuss the importance of smoking cessation and managing underlying medical conditions.
Review the planned treatment approach and potential risks and benefits.
Importance of good skin care and monitoring for signs of infection in the leg.
Follow-up
Schedule for follow-up appointments:
Monitor symptoms and ABI
Repeat imaging studies periodically to assess aneurysm size and patency (if treated with endovascular intervention)
Referral to a vascular surgeon for definitive management of complex cases or surgical intervention
Disclaimer: This information is for educational purposes only and should not be interpreted as medical advice. Please consult with a qualified healthcare professional for diagnosis and treatment of popliteal artery aneurysm.