Popliteal Artery Aneurysm Repair in the Endovascular Era. Issue 30 (July 2015)

• Record Type: Journal Article
• Authors: Ronchey, Sonia; Pecoraro, Felice; Alberti, Vittorio; Serrao, Eugenia; Orrico, Matteo; Lachat, Mario; Mangialardi, Nicola; Dai, Yamanouchi.
• Is Part Of: Medicine. Volume 94:Issue 30(2015)
• Publication Date: 2015-07
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000001130
• Languages: English
• ISSNs: 0025-7974

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Abstract</title> <p>To compare outcomes of popliteal artery aneurysm (PAA) repair by endovascular treatment, great saphenous vein (GSV) bypass, and prosthetic bypass.</p> <p>Single center retrospective analysis of patients presenting PAA from 2000 to 2013. Patients were divided into endovascular treatment (group A); GSV bypass (group B); and prosthetic graft bypass (group C). Outcomes were technical success, perioperative mortality, and morbidity. Survival, primary and secondary patency, and freedom from reintervention rate were estimated. Differences in ankle-brachial index (ABI), in-hospital length of stay (InH-Los), red blood cell (RBC) transfusion, and limb loss were reported. Mean follow-up was 49 (median: 35; 1–145; SD 42) months.</p> <p>Sixty-seven patients were included; 25 in group A, 28 in group B, and 14 in group C. PAA was symptomatic in 23 (34%) cases. Technical success was 100%. No perioperative death occurred. Three (4.5%) perioperative complications were reported with no significant difference between groups (<italic>P</italic> = 0.866). Five-years estimated survival was 78%. Estimated 5-years primary patency for groups A, B, and C was 71%, 81%, and 69%, respectively (<italic>P</italic> = 0.19). Estimated 5-years secondary patency for groups A, B, and C was 88%, 85%, and 84% (<italic>P</italic> = 0.85). Estimated 5-years freedom from reintervention for groups A, B, and C was 62%, 84%, and 70%, respectively (<italic>P</italic> = 0.16). A significant difference between preoperative ABI versus postoperative ABI was observed (<italic>P</italic> = 0.001). InH-LoS was significantly shorter in group A (<italic>P</italic> < 0.001). RBC transfusions were required significantly less in group A when compared to group C (<italic>P</italic> = 0.045). Overall limb salvage was achieved in all but 1 patient.</p> <p>PAA repair has good early and long-term outcomes with different treatment options. Endovascular treatment was not inferior to surgical repair with a reduced InH-LoS and RBC transfusion. It can be successfully employed even in nonelective setting. A randomized controlled trial with long-term follow-up and appropriate patient inclusion criteria is necessary to compare these 3 treatment options.</p> </sec> </abstract>