Thrombosed Popliteal Artery Aneurysm in the Functionally Dominant Limb After Contralateral Poliomyelitis: A Case Report

Popliteal artery aneurysms may cause thrombosis and chronic limb-threatening ischemia. Unilateral arteriomegaly is rare and may reflect long-term hemodynamic asymmetry after poliomyelitis. The objective of this study is to report diffuse unilateral lower-limb arteriomegaly with a thrombosed popliteal artery aneurysm in the functionally dominant limb contralateral to childhood poliomyelitis. A 53-year-old man with childhood right-leg poliomyelitis presented with left rest pain and an ischemic ulcer. Imaging demonstrated diffuse left lower-limb arteriomegaly, distal superficial femoral artery thrombosis, a thrombosed 30-mm popliteal aneurysm, anterior tibial artery occlusion, and posterior tibial artery stenosis. A mid-superficial femoral to posterior tibial vein bypass was performed, followed by balloon angioplasty of residual posterior tibial stenosis. At 3 months, rest pain had resolved, the ulcer had healed, and duplex demonstrated a patent graft. Lifelong asymmetric hemodynamic loading may contribute to arterial enlargement and aneurysmal degeneration in the functionally dominant limb after contralateral poliomyelitis.