Popliteal Aneurysms, Tailored Management Options; Single-Center Experience

Abstract

Backgroundː This study aims to review contemporary lines of management of popliteal artery
aneurysm (PAAs) illustrating the pros and cons of each treatment modality.
Methodsː This is a prospective cohort study of all consecutive PAAs treated between 2015-
2017. All patients Patients' data were entered into a prospectively designed registry including
all clinical, radiologic, operative and postoperative data.
Resultsː The study included thirty-seven PAAs in 35 patients. Management was by open
repair in 48.6%, while endovascular repair in 24.3%, primary major amputation in 5.4%, and
surveillance in 21.6%. PAAs were asymptomatic in 32.4% and symptomatic in 67.6% (acute
ischemia in 35.1%, claudication in 32.4%, rupture in 8.1% and leg swelling and pain in 8.1%).
An emergency procedure done in 29.7%, elective procedure in 51.4% and no intervention in
18.9%. Length of hospital stay in open repair was 15.1 days and in endovascular repair was 2
days. One year patency, limb salvage and mortality rates were 53.3%, 60% and 26.7%,
respectively in open repair and were 75%. 100%, and .0%, respectively in endovascular
repair (p=0.526).
Conclusionsː Results of repair of asymptomatic PAAs are significantly better than those in
symptomatic PAAs. In the emergency setting with severe limb ischemia and complete
thrombosis of PAAs, there is significantly increased mortality, limb loss, and decreased
primary patency rate. Endovascular treatment is feasible in selected patients with having
adequate landing zones. A prospective randomized trial is necessary to compare the
immediate and long-term outcome of endovascular repair with open repair in a large
population of patients with PAAs.