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01-12-2021 | Aneurysm | Original Article

Surgical Treatment of Asymptomatic Popliteal Artery Aneurysms and Mid-term Outcome

Authors: Metin Onur Beyaz, Emin Can Ata, İbrahim Demir, Mehmet Akif Önalan, Ömer Ali Sayın

Published in: Indian Journal of Surgery | Issue 6/2021

Abstract

Popliteal artery aneurysm (PAA) is a rare condition with an incidence ranging from 0.8 to 2.8%; however, it constitutes approximately 70–85% of all peripheral artery aneurysms. It is asymptomatic in the majority of cases but can cause pain and edema due to venous and neuronal compression. The most severe complication is limb lost due to thromboembolic event. Although surgical treatment left its place to endovascular treatment in the 1990s, surgical treatment still maintains its importance in preventing complications. Here, we aim to report our experience and results of the surgical management of popliteal aneurysms in this study. In this retrospective study, a total of 21 patients who were operated on due to popliteal artery aneurysm between October 2017 and January 2020 were analyzed. Patients with pseudoaneurysm and those who are infected and complicated were excluded from our study. The mean age was 63.3 ± 9.6; females were 17 (81%). Mean follow-up was 19 ± 8 months. More than two risk factors were found in 14 (66.7%) patients. Aneurysmectomy was performed successfully in all patients. Autologous saphenous vein graft was used in 11 (52.4%), whereas 6-mm polytetrafluoroethylene (PTFE) graft was preferred in 10 (47.6%) patients. During the follow-up period, limb loss rates were 16.7% and 83.3%, respectively. The difference was statistically significant (p < 0.05). No relation was found between the aneurysm diameter and postoperative graft occlusion. Limb loss rate was high in popliteal aneurysm repair using PTFE graft due to graft occlusion; saphenous vein graft is more superior in terms of mid-term graft patency.

Fang G, Chen B, Guo DQ et al (2020) Treatment of popliteal artery aneurysm-induced emergencies. Chin Med J 133(1):94–96. https://doi.org/10.1097/CM9.0000000000000575CrossRefPubMedPubMedCentral

Dubuis C, Déglise S, Saucy F et al (2013) Popliteal artery aneurysms: management in 2013. Rev Med Suisse 9(391):1299–1300 1302-4PubMed

Galland RB (2007) Popliteal aneurysms: from John Hunter to the 21st century. Ann R Coll Surg Engl 89(5):466–471. https://doi.org/10.1308/003588407X183472CrossRefPubMedPubMedCentral

Huang Y, Gloviczki P, Noel AA, Sullivan TM, Kalra M, Gullerud RE, Hoskin TL, Bower TC (2007) Early complications and long-term outcome after open surgical treatment of popliteal artery aneurysms: is exclusion with saphenous vein bypass still the gold standard? J Vasc Surg 45(4):706–715. https://doi.org/10.1016/j.jvs.2006.12.011CrossRefPubMed

Kropman RH, De Vries JP, Moll FL (2007) Surgical and endovascular treatment of atherosclerotic popliteal artery aneurysms. J Cardiovasc Surg 48(3):281–288

Wissgott C, Lüdtke CW, Vieweg H et al (2014) Endovascular treatment of aneurysms of the popliteal artery by a covered endoprosthesis. Clin Med Insights Cardiol 8(Suppl 2):15–21. Published 2014 Dec 21. https://doi.org/10.4137/CMC.S15232CrossRefPubMedPubMedCentral

Chen CH, Wen JS, Wang CK (2015) Huge pseudoaneurysm and cystic adventitial disease from popliteal artery entrapment. Circulation. 132(13):1284–1285. https://doi.org/10.1161/CIRCULATIONAHA.115.018399CrossRefPubMed

Idelchik GM, Dougherty KG, Hernandez E, Mortazavi A, Strickman NE, Krajcer Z (2009) Endovascular exclusion of popliteal artery aneurysms with stent-grafts: a prospective single-center experience. J Endovasc Ther 16(2):215–223. https://doi.org/10.1583/08-2412.1CrossRefPubMed

Jadhav S, Sanagar S, Kaushik S, Munde H (2019) Giant popliteal artery aneurysm in a teenager: an unusual occurrence. Korean J Thorac Cardiovasc Surg 52(2):116–118. https://doi.org/10.5090/kjtcs.2019.52.2.116CrossRefPubMedPubMedCentral

10.

Kassem MM, Gonzalez L (2019) Popliteal Arter Anevrizması. In: StatPearls. StatPearls Yayınları, Treasure Island (FL)

11.

Cross JE, Galland RB (2011) Part one: for the motion asymptomatic popliteal artery aneurysms (less than 3 cm) should be treated conservatively. Eur J Vasc Endovasc Surg 41(4):445–449. https://doi.org/10.1016/j.ejvs.2011.02.007CrossRefPubMed

12.

Martelli E, Ippoliti A, Ventoruzzo G, De Vivo G, Ascoli Marchetti A, Pistolese GR (2004) Popliteal artery aneurysms. Factors associated with thromboembolism and graft failure. Int Angiol 23(1):54–65PubMed

13.

Rutherford RB, Baker JD, Ernst C, Johnston KW, Porter JM, Ahn S, Jones DN (1997) Recommended standards for reports dealing with lower extremity ischemia: revised version [published correction appears in J Vasc Surg 2001 Apr;33(4):805]. J Vasc Surg 26(3):517–538. https://doi.org/10.1016/s0741-5214(97)70045-4CrossRefPubMed

14.

Ben Hammamia M, Ghedira F, Koubaa MA, Ben Mrad M, Ziadi J, Denguir R (2019) Traitement chirurgical des anévrismes poplités : résultats à court et à long termes [Short- and long-term outcomes of surgical treatment of popliteal aneurysms]. Ann Cardiol Angeiol (Paris) 68(4):215–220. https://doi.org/10.1016/j.ancard.2019.03.002CrossRef

15.

Cervin A, Ravn H, Björck M (2018) Ruptured popliteal artery aneurysm. Br J Surg 105(13):1753–1758. https://doi.org/10.1002/bjs.10953CrossRefPubMedPubMedCentral

16.

Stiegler H, Mendler G, Baumann G (2002) Prospective study of 36 patients with 46 popliteal artery aneurysms with non-surgical treatment. Vasa. 31(1):43–46. https://doi.org/10.1024/0301-1526.31.1.43CrossRefPubMed

17.

Jungi S, Kuemmerli C, Kissling P, Weiss S, Becker D, Schmidli J, Wyss TR (2019) Limb salvage by open surgical revascularisation in acute ischaemia due to thrombosed popliteal artery aneurysm. Eur J Vasc Endovasc Surg 57(3):393–398. https://doi.org/10.1016/j.ejvs.2018.09.030CrossRefPubMed

18.

Pulli R, Dorigo W, Castelli P, Dorrucci V, Ferilli F, de Blasis G, Monaca V, Vecchiati E, Benincasa A, Pratesi C (2013) A multicentric experience with open surgical repair and endovascular exclusion of popliteal artery aneurysms. Eur J Vasc Endovasc Surg 45(4):357–363. https://doi.org/10.1016/j.ejvs.2013.01.012CrossRefPubMed

19.

von Stumm M, Teufelsbauer H, Reichenspurner H, Debus ES (2015) Two decades of endovascular repair of popliteal artery aneurysm--a meta-analysis. Eur J Vasc Endovasc Surg 50(3):351–359. https://doi.org/10.1016/j.ejvs.2015.04.036CrossRef

20.

Antonello M, Frigatti P, Battocchio P, Lepidi S, Cognolato D, Dall’Antonia A, Stramanà R, Deriu GP, Grego F (2005) Open repair versus endovascular treatment for asymptomatic popliteal artery aneurysm: results of a prospective randomized study. J Vasc Surg 42(2):185–193. https://doi.org/10.1016/j.jvs.2005.04.049CrossRefPubMed

21.

Wagenhäuser MU, Herma KB, Sagban TA, Dueppers P, Schelzig H, Duran M (2015) Long-term results of open repair of popliteal artery aneurysm. Ann Med Surg (Lond) 4(1):58–63. Published 2015 Feb 11. https://doi.org/10.1016/j.amsu.2015.01.005CrossRefPubMedCentral

22.

Edwards WS (1969) Popliteal anevrizmaların dışlanması ve safen ven bypassı. Cerrahi, Kadın Hastalıkları ve Doğum 128(4):829–830

23.

de Alvarenga Yoshida R, Yoshida WB, Sardenberg T, Sobreira ML, Rollo HA, Moura R (2012) Fibular nerve injury after small saphenous vein surgery. Ann Vasc Surg 26(5):729.e11–729.e7.29E15. https://doi.org/10.1016/j.avsg.2011.11.042CrossRef

24.

Aragão JA, de Miranda FGG, Aragão ICS, Aragão FMS, Reis FP (2019) Treatment of bilateral popliteal artery aneurysms. J Vasc Bras 19:e20180142. Published 2019 Nov 29. https://doi.org/10.1590/1677-5449.180142CrossRefPubMedPubMedCentral

25.

Pulli R, Dorigo W, Troisi N, Innocenti AA, Pratesi G, Azas L, Pratesi C (2006) Surgical management of popliteal artery aneurysms: which factors affect outcomes? J Vasc Surg 43(3):481–487. https://doi.org/10.1016/j.jvs.2005.11.048CrossRefPubMed

Title: Surgical Treatment of Asymptomatic Popliteal Artery Aneurysms and Mid-term Outcome
Authors: Metin Onur Beyaz
Emin Can Ata
İbrahim Demir
Mehmet Akif Önalan
Ömer Ali Sayın
Publication date: 01-12-2021
Publisher: Springer India
Keywords: Aneurysm
Aneurysm
Published in: Indian Journal of Surgery / Issue 6/2021
Print ISSN: 0972-2068
Electronic ISSN: 0973-9793
DOI: https://doi.org/10.1007/s12262-021-02747-9

At a glance: The STEP trials

Springer Medicine

Surgical Treatment of Asymptomatic Popliteal Artery Aneurysms and Mid-term Outcome

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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