Popliteal artery aneurysms treatments: early midterm results of the use of endovascular stent grafts

Popliteal artery aneurysms treatments: early midterm results of the use of endovascular stent grafts

Background/aim: Popliteal artery aneurysms (PAAs) are abnormal bulgings, which account for 70% of all peripheral artery aneurysms. They are usually asymptomatic. In this study, we present our long-term results of endovascular stent grafts in the treatment of PAA in the light of literature data. Material and methods: A total of 63 legs of 63 patients with PAA, who were treated with endovascular techniques in our clinic between July 2010 and July 2019, were retrospectively analyzed. All patients underwent color Doppler ultrasound (DUS), magnetic resonance angiography (MRA), or computed tomography angiography (CTA) to identify the diameter and length of PAAs, vessel tortuosity, the presence and degree of thrombus, and diameter in the healthy landing zone and to visualize tibioperoneal vascular structures. A Viabahn stent graft was inserted in all patients. Results: 57 patients (90.5%) were males with a mean age of 76.35 ± 7 years. 24 patients (38.1%) were symptomatic, while 11 patients (17.5%) had a concomitant abdominal aortic aneurysm (AAA). The mean follow-up period was 46.05 ± 25.01 months. The primary patency rate was 79.3%. A graft thrombosis was observed in 13 patients (20.6%) during a mean follow-up period of 8.31 ± 5.91 months. The number of distal arteries was significantly lower in the patients with thrombosis than those without. Conclusions: Endovascular treatment of PAA using stentgrafts is safe in selected cases. However, it is reasonable to avoid endovascular treatment due to an increased risk for thrombosis in patients with a low number of patent distal arteries or impaired distal flow.Key words: Peripheral, vascular, stenting, aneurysm

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  • 1. Von Stumm M, Teufelsbauer H, Reichenspurner H, Debus ES. Two decades of endovascular repair of popliteal artery aneurysm. A meta-analysis. European Journal of Vascular and Endovascular Surgery 2015; 50, 351-359. doi: 10.1016/j. ejvs.2015.04.036
  • 2. Kropman RH, De Vries JP, Moll FL. Surgical and endovascular treatment of atherosclerotic popliteal artery aneurysms. The Journal of Cardiovascular Surgery (Torino) 2007; 48: 2 81-288.
  • 3. Rutherford RB. Arterial aneurysms. In: Cronenwett JL (editor). Rutherford’s Vascular Surgery. 6th ed. Philadelphia, PA, USA: Saunders; 2005. pp.1403-1408.
  • 4. Dawson I, Sie RB, Van Bockel JH. Atherosclerotic popliteal aneurysm. The British Journal of Surgery 1997; 84: 293-299.
  • 5. Kropman, R. H. J., Schrijver, A. M., Kelder, J. C., Moll, F. L., De Vries, J. P. P. M Clinical outcome of acute leg ischemia due to thrombosed popliteal artery aneurysm: systematic review of 895 cases. European Journal of Vascular and Endovascular Surgery 2010; 39: 452-457. doi:10.1016/j.ejvs.2009.11.010
  • 6. Wissgott C, Lüdtke CW, Vieweg H, Scheer F, Lichtenberg M et al. Endovascular treatment of aneurysms of the popliteal artery by a covered endoprosthesis. Clinical Medicine Insights. Cardiology. 2014; 8(Suppl 2): 15-21. doi: 10.4137/CMC.S15232
  • 7. Marin ML, Veith FJ, Panetta TF, Cynamon J, Bakal CW et al. Transfemoral endoluminal stented graft repair of a popliteal artery aneurysm. Journal of Vascular Surgery. 1994; 19 (4): 754-757. doi: 10.1016/s0741-5214(94)70052-4
  • 8. Wain RA, Hines G. A contemporary review of popliteal artery aneurysms. Cardiology in Review. 2007; 15 (2): 102-107. doi: 10.1097/01.crd.0000220212.52649.4a
  • 9. Curi MA, Geraghty PJ, Merino OA, Veeraswamy RK, Rubin BG et al. Mid-term outcomes of endovascular popliteal artery aneurysm repair. Journal of Vascular Surgery. 2007; 45 (3): 505-510. doi: 10.1016/j.jvs.2006.09.064
  • 10. Gawenda M, Sorgatz S, Müller U, Walter M, Erasmi H. The thrombosed popliteal artery aneurysm and distal arterial occlusion: successful therapy by interdisciplinary management. The Thoracic and Cardiovascular Surgeon. 1995; 43: 112-126. doi: 10.1055/s-2007-1013782
  • 11. Cross JE, Galland RB. Part one: for the motion asymptomatic popliteal artery aneurysms (less than 3 cm) should be treated conservatively. European Journal of Vascular and Endovascular Surgery. 2011; 41: 445-448. doi: 10.1016/j.ejvs.2011.02.007
  • 12. Dawson J, Fitridge R. Update on aneurysm disease: current insights and controversies: peripheral aneurysms: when to intervene-is rupture really a danger? Progress in Cardiovascular Diseases. 2013; 56: 26-35. doi: 10.1016/j.pcad.2013.05.002
  • 13. Whitehouse WM Jr, Wakefield TW, Graham LM, Kazmers A, Zelenock GB et al. Limb – threatening potential of arteriosclerotic popliteal artery aneurysms. Surgery. 1983; 93: 694-699.
  • 14. Antonello M, Frigatti P, Battocchio P, Lepidi S, Cognolato D et al. Open repair versus endovascular treatment for asymptomatic popliteal artery aneurysm: results of a prospective randomized study. Journal of Vascular Surgery. 2005; 42: 185-193. doi: 10.1016/j.jvs.2005.04.049
  • 15. Cervin A, Tjärnström J, Ravn H, Acosta S, Hultgren R et al. Treatment of popliteal aneurysm by open and endovascular surgery a contemporary study of 592 procedures in Sweden. European Journal of Vascular and Endovascular Surgery. 2015; 50: 342-350. doi: 10.1016/j.ejvs.2015.03.026
  • 16. Serrano Hernando FJ, Martínez López I, Hernández Mateo MM, Hernando Rydings M, Sánchez Hervás L et al. Comparison of popliteal artery aneurysm therapies. Journal of Vascular Surgery 2015; 61: 655-661. doi: 10.1016/j.jvs.2014.10.007
  • 17. Nelson PR, Anthony Lee W. Endovascular treatment of popliteal artery aneurysms. Vascular. 2006; 14 (5): 297-304. doi: 10.2310/6670.2006.00049
  • 18. Idelchik GM, Dougherty KG, Hernandez E, Mortazavi A, Strickman NE et al. Endovascular exclusion of popliteal artery aneurysms with stent-grafts: a prospective single-center experience. Journal of Endovascular Therapy 2009; 16: 215-223. doi: 10.1583/08-2412.1
  • 19. Piazza M, Menegolo M, Ferrari A, Bonvini S, Ricotta JJ et al. Long-term outcomes and sac volume shrinkage after endovascular popliteal artery aneurysm repair. European Journal of Vascular and Endovascular Surgery 2014; 48: 161-168. doi: 10.1016/j.ejvs.2014.04.011
  • 20. Lammer J, Zeller T, Hausegger KA, Schaefer PJ, Gschwendtner M et al. Heparin-bonded covered stents versus bare-metal stents for complex femoropopliteal artery lesions: the randomized VIASTAR trial (Viabahn endoprosthesis with PROPATEN bioactive surface (VIA) versus bare nitinol stent in the treatment of long lesions in superficial femoral artery occlusive disease). Journal of the American College of Cardiology 2013; 62: 1320-1327. doi: 10.1016/j.jacc.2013.05.079
  • 21. Siauw R, Koh EH, Walker SR. Endovascular repair of popliteal artery aneurysms: techniques,current evidence and recent experience. Australian and New Zealand Journal of Surgery 2006; 76: 505-511. doi: 10.1111/j.1445-2197.2006.03745.x
  • 22. Garg, K., Rockman, C. B., Kim, B. J., Jacobowitz, G. R., Maldonado, T. S et al. Outcome of endovascular repair of popliteal artery aneurysm using the Viabahn endoprothesis. Journal of Vascular Surgery 2012; 55 (6): 1647-1653. doi: 10.1016/j. jvs.2011.12.059
  • 23. Hernando, F. J. S., López, I. M., Mateo, M. M. H., Rydings, M. H., Hervás, L et al. Comparison of popliteal artery aneurysm therapies. Journal of Vascular Surgery 2015; 61: 655-661. doi: 10.1016/j.jvs.2014.10.007
  • 24. Tielliu IF, Verhoeven EL, Zeebregts CJ, Prins TR, Span MM et al. Endovascular treatment of popliteal artery aneurysms: results of a prospective cohort study. Journal of Vascular Surgery 2005; 41: 561-567. doi: 10.1016/j.jvs.2004.12.055
  • 25. Galland RB, Magee TR. Popliteal aneurysms: distortion and size related to symptoms. Journal of Vascular and Endovascular Surgery 2005; 30 (5): 534-538. doi: 10.1016/j.ejvs.2005.05.021
  • 26. Antonello M, Frigatti P, Battocchio P, Lepidi S, Dall’Antonia A et al. Endovascular treatment of asymptomatic popliteal aneurysm:8-year concurrent comparison with open repair. The Journal of Cardiovascular Surgery (Torino) 2007; 48 (3): 267- 274.
  • 27. Midy D, Berard X, Ferdani M, Alric P, Brizzi V et al. A Retrospective multicenter study of endovascular treatment of popliteal artery aneurysm. Journal of Vascular Surgery 2012; 51: 850-856. doi: 10.1016/j.jvs.2009.10.107
  • 28. Stone PA, Jagannath P, Thompson SN, Campbell JE, Mousa AY et al. Evolving treatment of popliteal artery aneurysms. Journal of Vascular Surgery 2013; 57: 1306-1310. doi: 10.1016/j. jvs.2012.10.122
  • 29. Galiñanes EL, Dombrovskiy VY, Graham AM, Vogel TR. Endovascular versus open repair of popliteal artery aneurysms: outcomes in the US Medicare population. European Journal of Vascular and Endovascular Surgery 2013; 47: 267-273. doi: 10.1177/1538574413475888
  • 30. Ucci A, Curci R, Azzarone M, Bianchini Massoni C, Bozzani A et al. Early and mid-term results in the endovascular treatment of popliteal aneurysms with the multilayer flow modulator. Vascular 2018; 26 (5): 556-563. doi: 10.1177/1708538118771258
  • 31. Elif Coşkun, Levent Altınay, Anıl Tekin, Ufuk Tütün. Endovascular treatment of popliteal artery aneurysms: A report of three cases. Turkish Journal of Vascular Surgery 2020; 29 (1): 59-62. doi: 10.9739/tjvs.2020.258
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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