Superficial femoral artery autograft reconstruction in the treatment of popliteal artery aneurysm: Long-term outcome

Abstract

Objective: This prospective, observational study evaluated the safety and efficacy of superficial femoral artery autograft reconstruction in the treatment of popliteal artery aneurysms in the absence of a suitable saphenous vein. Methods: From March 1997 to April 2007, data from patients with popliteal artery aneurysms treated by superficial femoral artery reconstruction were prospectively collected in two centers. The procedure was performed through a medial approach. The superficial femoral artery was harvested in the upper third of the thigh and used as the conduit for reconstruction, and the harvested segment was replaced by a polytetrafluoroethylene graft. The patients were observed for survival, limb salvage, and reconstruction patency. The results were calculated by the Kaplan-Meier method. Results: During the 10-year study period, 37 popliteal artery aneurysms in 32 patients (all men; median age, 71 years) were treated by reconstruction using the superficial femoral artery. Indications for surgical treatment were symptomatic or complicated aneurysms in 11 (30%). Four (11%) of the 37 popliteal artery aneurysms were thrombosed, and 33 (89%) were patent. At surgery, 35% had a single vessel runoff. Because of acute ischemia, reconstruction was performed as an emergency procedure in three patients (8%). There were no perioperative deaths, early amputations, or early thrombosis. The mean follow-up period was 36 months (range, 7-103 months). Two grafts thrombosed during follow-up. At 3 years, the primary and secondary patency rates were 86% and 96%, and overall limb salvage was 100%. Follow-up duplex ultrasonography did not detect any aneurysmal dilatation of the autograft. Conclusion: Our experience shows that superficial femoral arterial reconstruction is a safe and useful treatment option in patients with popliteal artery aneurysms who lack suitable saphenous veins. This reconstruction seems to be a good alternative to prosthetic bypass crossing the knee joint, and our results suggest that this study should be continued. ( J Vasc Surg 2008;48:311-6.)

Superficial Femoral Artery Autograft Reconstruction for Complicated Popliteal Artery Entrapment Syndrome

“…There was no aneurysmal dilatation of the autograft in followup duplex ultrasound. 9 To our knowledge, reconstruction with femoral artery autografts has never been reported for revascularization of complicated PAES. The main advantages of this autograft as an alternative reconstruction material are its good reliability when positioned across the articular midline and excellent congruence for both anastomoses, allowing end-toend anastomosis.…”

Superficial femoral artery as a graft material by performing an iliacofemoral in situ bypass for leg stump salvage: Case report

“…7 The SFA has been shown to be a material of choice for renal arteries and supra-aortic vessels reconstruction, especially in young patients with complex reconstruction or Takayasu disease and in patients presenting with infection or previous radiation. 8 SFA can be easily harvested, has an adequate wall thickness, and is easy to handle even in deep regions; anastomosis is thus relatively easy to perform. 9 SFA autografts (SFAA) have also becomem choice for popliteal reconstruction when the ipsilateral GSV is not suitable.…”

“…9 SFA autografts (SFAA) have also becomem choice for popliteal reconstruction when the ipsilateral GSV is not suitable. 8 On the other side, an arterial bypass graft may develop a hemodynamically significant stenosis at either anastomosis (proximal or distal), within the body of the graft, or in the native arterial inflow/outflow separate from the reconstruction. 10 Standard teaching for treatment of infected vascular grafts is extra anatomical bypass grafting whilst commencing appropriate antibiotics.…”

Use of a Superficial Femoral Artery Autograft as a Femoral Vein Replacement

“…6 Utilization of the SFA as an autograft has been reported for popliteal aneurysm repair and carotid artery reconstruction in the absence of conventional venous conduits. 7,8 Ghosh et al 9 reported successful use of an SFA autograft as a femoral vein replacement on a 46-year-old-man during en bloc sarcoma resection. The PTFE graft is used for the reconstruction of the SFA, which is a large caliber artery and has any signs of atherosclerotic disease, which may result in early occlusion or stenosis in the near future.…”