Endovascular and Open Approaches to Non-thrombosed Popliteal Aneurysm Repair: A Meta-analysis

Lovegrove, R E; Javid, Mahsa; Magee, T.R.; Galland, R. B.

doi:10.1016/j.ejvs.2008.02.002

Cited by 94 publications

(25 citation statements)

References 32 publications

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“…11 This trend could be questioned on the basis the results of this study. 11,12 For the first time it has been possible to Figure 3. Flow chart of treatment given in the subgroup treated for acute ischaemia.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Popliteal Aneurysm by Open and Endovascular Surgery: A Contemporary Study of 592 Procedures in Sweden

Cervin¹,

Tjärnström²,

Ravn³

et al. 2015

Journal of Vascular Surgery

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Treatment of Popliteal Aneurysm by Open and Endovascular Surgery: A Contemporary Study of 592 Procedures in SwedenCervin, A.; Tjarnstrom, J.; Ravn, H.; Acosta, Stefan; Hultgren, R.; Welander, M.; Bjorck, M. Link to publication Citation for published version (APA): Cervin, A., Tjarnstrom, J., Ravn, H., Acosta, S., Hultgren, R., Welander, M., & Bjorck, M. (2015). Treatment of Popliteal Aneurysm by Open and Endovascular Surgery: A Contemporary Study of 592 Procedures in Sweden. European Journal of Vascular and Endovascular Surgery, 50(3), 342-350. DOI: 10.1016/j.ejvs.2015.03.026 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal WHAT THIS STUDY ADDSPrevious comparisons between open and endovascular repair of popliteal aneurysms have focused on asymptomatic patients, and have short follow up. This study is strengthened by the fact that it is contemporary, population based, without any selection bias, reporting on all kinds of presentations, and has approximately 90% 1 year follow up data. It shows that endovascular repair has significantly inferior results compared with open repair, in particular in the group of patients who present with acute ischaemia. We believe these results will make many vascular surgeons think twice before they treat patients endovascularly in the future. Background: Popliteal aneurysm (PA) is traditionally treated by open repair (OR). Endovascular repair (ER) has become more common. The aim was to describe time trends and compare results (OR/ER).Methods: The Swedish vascular registry, Swedvasc, has a specific PA module. Data were collected (2008e2012) and supplemented with a specific protocol (response rate 99.1%). Data were compared with previously published data (1994e2002) from the same database.Results: The number of operations for PA was 15.7/million person-years (8.3 during 1994e2001). Of 592 interventions for PA (499 patients), 174 (29.4%) were treated for acute ischaemia, 13 (2.2%) for rupture, 105 (17.7%) for other symptoms, and 300 (50.7%) were asymptomatic (31.5% were treated for acute ischaemia, 1994e2002, p ¼ .58). There were no differences in background characteristics between OR and ER in the acute ischaemia group. The symptomatic and asymptomatic groups treated with ER were older (p ¼ .006, p < .001). ER increased 3.6 fold (4.7% 1994e2002, 16.7% 2008e2012, p ¼ .0001 Conclusions: The number of operations for PA doubled while the indications remained similar. ER patency was inferior to OR, especially after treatment for acute...

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Section: Discussionmentioning

confidence: 99%

Treatment of Popliteal Aneurysm by Open and Endovascular Surgery: A Contemporary Study of 592 Procedures in Sweden

Cervin¹,

Tjärnström²,

Ravn³

et al. 2015

Journal of Vascular Surgery

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“…[13]. Lovegrove et al in a recent meta-analysis reported that endovascular repair of PAAs offers similar medium-term benefits but higher rates of early graft thrombosis and early interventions compared to open repair [14]. It is clear that although different case series [15, 16] and reports suggest the utility and technical success of endoluminal approach, long-term patency rates of endovascular repair of PAAs are still awaited.…”

Section: Discussionmentioning

confidence: 99%

One-Stage Hybrid Repair of Multiple Degenerative Aneurysms

Kouvelos

Papa

Αrnaoutoglou

et al. 2012

Case Reports in Vascular Medicine

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The development of multiple aneurysms in different segments of the arterial tree requiring treatment is a challenge for the vascular surgeon as their management often demands more than one surgical procedure. We report a case of a 71-year-old male suffering from multiple aneurysms in four different segments of the arterial tree in combination with disabling claudication of his left leg. The patient was managed in a single session with a combination of classic open surgical and endovascular techniques in order to treat his aneurysms and revascularize his leg. This case illustrates the prospect to combine classic open surgical and endovascular techniques for the optimal management of multileveled arterial pathology. Combined therapy simplifies management and allows the one-stage treatment of these patients, while minimizing the overall operative risk.

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“…9,10,15,19,[35][36][37][38][39][40] Several studies have reported complications including thrombosis, endoleaks, stent migration and stent fractures, which can be as high as 9.60% in the case of type 2 endoleaks, although the great majority are self-limiting and do not lead to expansion of the aneurysm sac. 24,39,41 Previous studies have reported higher rates of reintervention after ES, which was not the case in our series, 9 probably because of the small number of ES and the short follow-up. These rates are the reason why careful monitoring of patients who have undergone popliteal aneurysm repair is necessary, whether treated with endovascular or open surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Asymptomatic aneurysms smaller than 2.0 cm and diameter without thrombus are monitored periodically using Doppler ultrasound. 8,9 Open surgery is most widely employed and the preferred technique is a bypass, using a medial approach, proximal and distal ligature of the aneurysm and an inverted great saphenous vein graft. As endovascular techniques develop, new approaches to management of popliteal aneurysms are being studied, in the hope of achieving lower complication rates.…”

Section: Introductionmentioning

confidence: 99%

Cirurgia aberta e endovascular no tratamento de aneurisma de artéria poplítea: experiência de cinco anos do HCRP-FMRP-USP

et al. 2015

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Background: popliteal artery aneurysms (PAAs) account for 70% of peripheral aneurysms. Surgery is indicated for aneurysms that have diameters greater than 2.0 cm or are symptomatic. Repair can be achieved by conventional surgical techniques or using endovascular methods, which are becoming increasingly popular, but for which there is not yet a consensus on indications. Objective: To describe the experience of treating PAAs at the vascular and endovascular surgery department of the Hospital das Clínicas de Ribeirão Preto, affiliated to the Universidade de São Paulo (Brazil). Method: A review was conducted of cases of conventional and endovascular repair of PAAs over the last 5 years, analyzing demographic data, comorbidities, surgical indications, preoperative and early and late postoperative complications, length of hospital stay and patency, during follow-up of up to 1 year. Results: During the period analyzed, ten endovascular surgeries (ES) and 21 open surgeries (OS) were performed. The ES group exhibited a higher frequency of comorbidities. There was a higher frequency of symptomatic patients in the OS group (85%) than in the ES group (40%). The ES group exhibited a lower number of clinical and surgical complications. There were no statistical differences between the groups in terms of age or length of hospital stay. Primary patency at 1 year was 80% in the ES group and 75% in the OS group. Conclusions: Endovascular treatment for PAAs offers good results in terms of patency, with acceptable complication rates, in patients with high surgical risk and favorable anatomy. Controlled studies are therefore warranted to validate the endovascular technique and afford it the status of an alternative procedure for use in selected cases.

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Endovascular and Open Approaches to Non-thrombosed Popliteal Aneurysm Repair: A Meta-analysis

Cited by 94 publications

References 32 publications

Treatment of Popliteal Aneurysm by Open and Endovascular Surgery: A Contemporary Study of 592 Procedures in Sweden

Treatment of Popliteal Aneurysm by Open and Endovascular Surgery: A Contemporary Study of 592 Procedures in Sweden

One-Stage Hybrid Repair of Multiple Degenerative Aneurysms

Cirurgia aberta e endovascular no tratamento de aneurisma de artéria poplítea: experiência de cinco anos do HCRP-FMRP-USP

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