Surgery of popliteal artery aneurysms: A 12-year experience

Mahmood, Ansar; Salaman, Robert; Sintler, Martin; Smith, S.R.G.; Simms, M.H.; Vohra, Rajiv

doi:10.1067/mva.2003.141

Cited by 131 publications

(128 citation statements)

References 25 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.…”

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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“…The published mortality for infra inguinal aneurysms varies depending on the type and site of aneurysm, with 30-day mortality for all popliteal aneurysms ranging up to 14% [31,32] and 30-day mortality for all femoral pseudoaneuryms quoted at 4% [33].…”

Section: Discussionmentioning

confidence: 99%

Infra-Inguinal Aneurysms – Threat to Life and Limb?

Moussa¹

2016

Int J Vasc Surg Med

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“…Matas, in 1885, developed the endoaneurysmorrhaphy technique, which lowered the limb amputation rate from 10.5% to 5.2%. [14][15][16] In 1969, Edwards 7 proposed a surgical technique with minor trauma, and this has become the most common method of repair since then. 3 The technique is an alternative to extensive exposure through the section of the tendons of the semimembranosus, gracilis, semitendinosus and sartorius muscles, and medial head of the gastrocnemius muscle, steps that are essential in the medial exposure of the popliteal artery, opening of the aneurysmal sac, ligation of collateral branches, and graft interposition.…”

Section: Discussionmentioning

confidence: 99%

Follow-Up of the Aneurysmal Sac After Exclusion and Bypass of Popliteal Artery Aneurysms

Wakassa

Matsunaga

Silva

et al. 2006

Clinics

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Popliteal artery aneurysms are frequent and may lead to thromboembolic events and limb loss. PURPOSE: To evaluate clinical and ultrasonographic follow-up of patients who underwent exclusion of a popliteal artery aneurysm using the technique proposed by Edwards. METHODS: Data of all patients who underwent surgery to repair a popliteal artery aneurysm at Hospital das Clinicas, the São Paulo University Medical School between 1996 and 2004 were reviewed. Inclusion criteria were repair with aneurysm exclusion and bypass using the technique proposed by Edwards, as well as the existence of preoperative and postoperative measurements of the aneurysmal sac. RESULTS: Data of 16 patients who underwent 20 procedures for popliteal artery aneurysm exclusion and bypass were available to analysis. The preoperative diameter of the popliteal artery aneurysms ranged from 1.3 cm to 6.1 cm (mean = 3.1 cm). Patients underwent duplex ultrasound scanning 1 month to 7 years after surgical repair. Follow-up of the 20 cases revealed that 10 aneurysms exhibited decreased mean transverse diameters, ranging from 0.2 to 2.3 cm, while 7 had increased in diameter, ranging 0.3 to 3.3 cm, and 3 remained unchanged. Flow was observed only in 5 outo f the 20 procedures, 3 of which (60%) had increased diameters. CONCLUSION: Although exclusion is a widely accepted procedure for the repair of popliteal artery aneurysms, data in the literature and the results of this study, which did not include cases of rupture or compression, suggest that strict follow-up of patients who undergo aneurysm exclusion is necessary.

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Surgery of popliteal artery aneurysms: A 12-year experience

Abstract: Thromboembolectomy followed by crural bypass grafting is an effective treatment for popliteal aneurysm with severe acute limb ischemia. Outcome is better with surgical management of asymptomatic popliteal aneurysm compared with symptomatic aneurysm.

Cited by 131 publications

References 25 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

Infra-Inguinal Aneurysms – Threat to Life and Limb?

Follow-Up of the Aneurysmal Sac After Exclusion and Bypass of Popliteal Artery Aneurysms

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