Popliteal artery aneurysms: a comparison of outcomes in elective versus emergent repair

Aulivola, Bernadette; Hamdan, Allen D.; Hile, Chantel; Sheahan, Malachi; Skillman, John J.; Campbell, David R.; Scovell, Sherry D.; LoGerfo, Frank W.; Pomposelli, Frank B.

doi:10.1016/j.jvs.2003.12.023

Cited by 99 publications

(106 citation statements)

References 14 publications

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“…8e10, 15,16 On the basis of these results and considering the high risk of severe complications in patients with untreated aneurysms, 17,18 it is nowadays accepted that the indication for treatment is the presence of asymptomatic aneurysms larger than 20 mm in patients at low surgical risk. 6 Also in symptomatic lesions, particularly in the presence of limb-threatening ischemia due to PAA thrombosis or embolization, results of open surgery, even if poorer than those obtained in elective situations, 19 are still satisfactory, 20 provided that an aggressive policy of tibial salvage, including preoperative and intraoperative thrombolysis, 5 is adopted. In the past decade, with the introduction and wide diffusion of endovascular techniques also in peripheral arterial district and with the development of low-profile flexible cover-stents for distal applications, endovascular repair has been proposed for the treatment of PAAs, and promising results have been reported by different authors.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Early and Midterm Results of Open and Endovascular Treatment of Popliteal Artery Aneurysms

Pulli¹,

Dorigo²,

Fargion³

et al. 2012

Annals of Vascular Surgery

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Background: Aim of this study was to retrospectively compare perioperative (<30 days) and 2-year results of open and endovascular management of popliteal artery aneurysms (PAAs) in a single-center experience. Methods: From January 2005 to December 2010, 64 PAAs in 59 consecutive patients were operated on at our institution; in 43 cases, open repair was performed (group 1), whereas the remaining 21 cases had an endovascular procedure (group 2). Data from all the interventions were prospectively collected in a dedicated database, which included main preoperative, intraoperative, and postoperative parameters. Early results in terms of mortality, graft thrombosis, and amputation rates were analyzed and compared by c 2 text or Fisher exact text. The surveillance program consisted of clinical and ultrasonographic examinations at 1, 6, and 12 months and yearly thereafter. Follow-up results (survival, primary and secondary patency, limb salvage) were analyzed by KaplaneMeier curves, and differences in the two groups were assessed by log-rank test. Results: There were no differences between the two groups in terms of sex, age, risk factors for atherosclerosis, and comorbidities; PAAs were symptomatic in 48% of cases in group 1 and in 29% in group 2 (P ¼ 0.1). Fifteen patients with mild-to-moderate acute ischemia due to PAA thrombosis underwent preoperative intra-arterial thrombolysis, 13 in group 1 and 2 in group 2. In open surgery group, nine cases were treated with aneurysmectomy and prosthetic graft interposition, and in seven cases, the aneurysm was opened and a prosthetic graft was placed inside the aneurysm. In 27 cases, ligation of the aneurysm with bypass grafting (21 prosthetic grafts and 6 autologous veins) was carried out. In group 2, 20 patients had endoprosthesis placement, whereas in the remaining patient, a multilayer nitinol stent was used. There was one perioperative death in a patient of group 2 who underwent concomitant endovascular aneurysm repair and PAA endografting. Cumulative 30-day death and amputation rate was 4.5% in group 1 and 4.7% in group 2 (P ¼ 0.9). Follow-up was available in 61 interventions (96%) with a mean follow-up period of 22.5 months (range: 1e60). Estimated primary patency rates at 24 months were 78.1% in group 1 and 59.4% in group 2 (P ¼ 0.1). Freedom from reintervention rates at 24 months were 79% in group 1 and 61.5% in group 2 (P ¼ 0.2); estimated 24-month secondary patency rates were 81.6% in group 1 and 78.4% in group 2 (P ¼ 0.9), and freedom from amputation rates were 92.7% and 95%, respectively (P ¼ 0.7). Conclusions: Endovascular treatment of PAAs provided, in our initial experience, satisfactory perioperative and 1-year results, not significantly different from those obtained with prosthetic

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Section: Discussionmentioning

confidence: 99%

Comparison of Early and Midterm Results of Open and Endovascular Treatment of Popliteal Artery Aneurysms

Pulli¹,

Dorigo²,

Fargion³

et al. 2012

Annals of Vascular Surgery

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“…They are frequently observed in men 1 . A paa may cause a variety of compressive and occlusive complications.…”

Section: Introductionmentioning

confidence: 99%

A giant thrombotic popliteal aneurysm with concomitant entrapment neuropathy and critical limb ischemia

Keskin¹,

Çelik²,

Karagöz³

et al. 2015

Cumhuriyet Med J

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SUMMARYPopliteal artery aneurysms are relatively common among all peripheral aneurysms. Nevertheless development of entrapment neuropathy or critical limb ischemia due to a popliteal aneurysm is extremely rare. Peripheral nerves such as tibial and common peroneal nerves are more frequently exposed to chronic compression due to settlement with a narrow anatomic volume and neighborhood with a joint. Herein we present a case of a thrombotic popliteal aneurysm causing entrapment neuropathy and critical limb ischemia.

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“…Factors affecting the decision to intervene PAA are the incidence and speed of symptoms, size of aneurysm in diameter, mural thrombus, and the presence of thromboembolic history (1,3,4). Many authors recommend elective intervention in terms of thromboembolic risks for mural thromboses larger than 20 mm in asymptomatic patients (5,10). Patients with untreated PAAs tend to have an increased risk of complications over time; Galland et al's study has put forward that asymptomatic PAA has the risk of becoming symptomatic by 14% annually (11).…”

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confidence: 99%

The Case of a Patient with Concomitant Popliteal Artery and Ascending Aortic Aneurysm Who Presented with the Blue Toe Syndrome

2015

J Turgut Ozal Med Cent

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Popliteal artery aneurysms (PAAs) are rare though these aneurysms are the most frequently encountered peripheral arterial aneurysms. In this article, we present the treatment of a patient who simultaneously had bilateral popliteal artery and ascending aortic aneurysm but was admitted to the emergency room due to the blue toe syndrome. A 72-old-year female was admitted to the hospital with left lower extremity pain and cyanosis in her toe. Bilateral popliteal artery and ascending aortic aneurysm were observed on computed tomography. Aneurysmectomy and femoropopliteal bypass was performed primarily to the left popliteal artery owing to ischemia. Two months later, we performed valve and ascending aorta replacement followed by right popliteal aneurysmectomy and femoropopliteal bypass 16 months later. In conclusion, since other arterial aneurysms can be simultaneously observed with popliteal artery aneurysm, it is very important to scan whole main arterial system when PAA is evaluated.

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Popliteal artery aneurysms: a comparison of outcomes in elective versus emergent repair

Cited by 99 publications

References 14 publications

Comparison of Early and Midterm Results of Open and Endovascular Treatment of Popliteal Artery Aneurysms

Comparison of Early and Midterm Results of Open and Endovascular Treatment of Popliteal Artery Aneurysms

A giant thrombotic popliteal aneurysm with concomitant entrapment neuropathy and critical limb ischemia

The Case of a Patient with Concomitant Popliteal Artery and Ascending Aortic Aneurysm Who Presented with the Blue Toe Syndrome

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