Clinical Presentation

A 48-year-old man presents to the emergency department with a cold right foot.

(A) Computed tomographic angiogram (CTA) shows large aneurysms in the right superficial femoral and popliteal arteries (arrows). (B) Axial images show extensive intraluminal thrombus narrowing the lumen (arrowhead); conventional angiography underestimates the aneurysmal size (arrows).

Differential Diagnosis

• Popliteal artery aneurysm (PAA): Indicated by fusiform dilatation > 1.2 cm and at least 1.5 times the luminal diameter of the proximal arterial segment.
  
• Vascular ectasia: Would be indicated by a dilated PA without frank PAA.

Essential Facts