Surgical repair of popliteal artery aneurysms remains a safe treatment option in the endovascular era: a 10-year single-center study

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COD: 06_2011_443-448 Categorie: ,

Umberto Marcello Bracale, Giuseppe Corte, Antonella Di Gregorio, Felice Pecoraro, Pietro Machì, Filippo Rusignuolo, Guido Bajardi

Ann. Ital. Chir., 2011 82: 443-448

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INTRODUCTION: Endovascular popliteal artery aneurysm repair has emerged recently as a feasible alternative to standard
surgical repair. However, the evidence from the literature is still limited, with only case reports, case series and one small
randomized trial. Currently, the available data suggests that stent-grafts should be used in patients at very high surgical
risk. The purpose of this study is to present our surgical experience in popliteal artery aneurysm repair in an endovascular
era.
MATERIALS AND METHODS: Data from 36 consecutive patients, who were admitted to our hospital from January 2000
to April 2010, was analyzed retrospectively. Twenty-six patients underwent surgical treatment through medial or posterior
access. The posterior approach was used preferentially. The medial approach was adopted in patients with large
aneurysms or aneurysms involving the superficial femoral artery.
RESULTS: Twelve patients (Group A; 46.1%) were operated on via medial access followed by femoropopliteal bypass. In
the remaining fourteen patients (Group B; 53.9%) an interposition graft was performed via a posterior approach. The
30-day overall mortality rate was 3.8% (1/26). The 30-day amputation rate was 0% in both groups. The primary
patency rate was 83.3% in Group A at 78.8-month average follow-up (range: 18-128 months) and was 100% in
Group B at 46.3-month average follow-up (range: 5-121 months).
CONCLUSION: Notwithstanding the extensive use of stent-grafts worldwide, surgical repair remains the gold standard for
the management of popliteal artery aneurysms. In our experience open repair using either a medial or posterior approach
is associated with low mortality and morbidity rates.

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