Cardiovascular Risk Reduction is Important for Improving Patient and Graft Survival After Ligation and Bypass Surgery for Popliteal Artery Aneurysm

Abstract

Objectives:To report outcomes following ligation and bypass (LGB) surgery for popliteal artery aneurysm (PAA) and study factors influencing patient and graft survival. Materials and Methods:A retrospective review of patients undergoing LGB surgery for PAA between September 1999 and August 2012 at a tertiary referral vascular unit was performed. Primary graft patency (PGP), primary-assisted graft patency (PAGP), and secondary graft patency (SGP) rates were calculated using survival analyses. Patient, graft aneurysm-free survival (GAFS), aneurysm reperfusion-free survival (ARFS), and amputation-free survival (AFS) rates were also calculated. Log-rank testing and Cox proportional hazards modeling were used to perform univariate and multivariate analysis of influencing factors, respectively. Results:Eighty-four LGB repairs in 69 patients (mean age 71.3 years, 68 males) were available for study.The 5-year PGP, PAGP, SGP, and patient survival rates were 58.1%, 84.4%, 85.2%, and 81.1%, respectively. On multivariate analysis, the principal determinants of PGP were urgency of operation (P = .009) and smoking status (P = .019). The principal determinants of PAGP were hyperlipidemia status (P = .048) and of SGP were hyperlipidemia (P = .042) and cerebrovascular disease (CVD) status (P = .045). The principal determinants of patient survival were previous myocardial infarction (P = .004) and CVD (P = .001). The 5-year GAFS, ARFS, and AFS rates were 87.9%, 91.6%, and 96.1%, respectively. Conclusion:This study has shown that traditional cardiovascular risk factors, such as a smoking and ischemic heart disease, are the most important predictors of early graft failure and patient death followingLGB surgery for PAA.

Open repair of a symptomatic popliteal artery aneurysm in a 71-year-old patient: Case report

“…Vascular cross-clamps were placed above the PAA on the DSFA to cardiovascular risk reduction (blood pressure control, dietary adjustments and smoking abstinence, antiplatelet treatment, normal blood glycaemia) can prolong grafts' patency and improves patients' survival. 13 An alternative treatment option for PAA is the use of endovascular devices. A study by Cervin et al had demonstrated inferior results of endovascular devices when compared to open repair.…”