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Different approaches in popliteal artery aneurysm management

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Summary

Background

The purpose of the popliteal aneurysm surgical treatment is the prevention of thromboembolic events or the increase of the aneurysm size. Our prospectively collected data were analyzed with the aim to identify factors that could characterize the immediate and long-term success of the treatment, with particular regards to quality of life in terms of early recovery.

Materials and methods

From July 2004 to September 2012, 36 patients affected by 39 popliteal aneurysms have been treated. A total of 16 posterior accesses, 5 medial accesses, 12 above and below the knee joint medial accesses, and 6 endovascular accesses have been performed. Functional recovery, quality of life, as well as primary and secondary patency have been compared for different access.

Results

A complete sac excision before the graft repair has been obtained for all patients subjected to posterior or medial access with section of the goose foot tendons. The posterior access functional recovery has been compared with that of the patients subjected to medial access in terms of motility (p = 0.0001). The average follow-up was 27 months; the primary patency was 87 % and the secondary one 96 %. The limb salvage rate was 100 %.

Conclusions

The posterior access offers a better aneurysm exposure and a better functional recovery.

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References

  1. Dawson I, Sie RB, van Bockel JH. Atherosclerotic popliteal aneurysm. Br J Surg. 1997;84:293–9.

    Article  PubMed  CAS  Google Scholar 

  2. Duffy ST, Colgan MP, Sultan S, Moore DJ, Shanik GD. Popliteal aneurysms: a 10-year experience. Eur J Vasc Endovasc Surg. 1998;16:218–22.

    Article  PubMed  CAS  Google Scholar 

  3. Pulli R, Dorigo W, Troisi N, Innocenti AA, Pratesi G, Azas L, et al. Surgical management of popliteal artery aneurysms: which factors affect outcomes? J Vasc Surg. 2006;43:481–7.

    Article  PubMed  Google Scholar 

  4. Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, et al. ACC/AHA guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Associations for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (writing committee to develop guidelines for the management of patients with peripheral arterial disease). Summary of recommendations. Circulation. 2006;113:463–654.

    Article  Google Scholar 

  5. Henke PK. Popliteal artery aneurysms: tried, true, and new approaches to therapy. Semin Vasc Surg. 2005;18:224–30.

    Article  PubMed  Google Scholar 

  6. Mousa AY, Beauford RB, Henderson P, Patel P, Faries PL, Flores L, Fogler R. Update on the diagnosis and management of popliteal aneurysm and literature review. Vascular. 2006;4:103–8.

    Article  Google Scholar 

  7. Galland RB. Popliteal aneurysms: from John Hunter to the 21st century. Ann R Coll Surg Engl. 2007;89:466–71.

    Article  PubMed  CAS  Google Scholar 

  8. Loukas M, Klaasen Z, Tubbs RS, Apaydin N. Popliteal artery aneurysms: a review. Folia Morphol (Warsz). 2007; 66:272–6.

  9. Whitehouse WM Jr, Wakefield TW, Graham LM, et al. Limb-threatening potential of arteriosclerotic popliteal artery aneurysms. Surgery. 1983;93:694–9.

    PubMed  Google Scholar 

  10. Carpenter JP, Barker CF, Roberts B, et al Popliteal artery aneurysms: current management and outcome. J Vasc Surg. 1994;19:65–72; discussion 72–3.

    Google Scholar 

  11. Dawson I, Sie R, van Baalen JM, van Bockel JH. Asymptomatic popliteal aneurysm: elective operation versus conservative follow-up. Br J Surg. 1994;81:1504–7.

    Article  PubMed  CAS  Google Scholar 

  12. Cross JE, Galland RB, Hingorani A, Ascher E. Nonoperative versus surgical management of small (less than 3 cm), asymptomatic popliteal artery aneurysms. J Vasc Surg. 2011;53:1145–8.

    Article  PubMed  Google Scholar 

  13. Ascher E, Markevich N, Schutzer RW, et al. Small popliteal artery aneurysms: are they clinically significant? J Vasc Surg. 2003;37:755–60.

    Article  PubMed  Google Scholar 

  14. Dawson I, van Bockel JH, Brand R, Terpstra JL. Popliteale artery aneurysms. Long-term follow-up of aneurysmal disease and results of surgical treatment. J Vasc Surg. 1991;13:398–407.

    Article  PubMed  CAS  Google Scholar 

  15. Lowell RC, Gloviczki P, Hallett JW Jr, et al. Popliteal artery aneurysms: the risk of nonoperative management. Ann Vasc Surg. 1994;8:14–23.

    Article  PubMed  CAS  Google Scholar 

  16. Shortell CK, DeWeese JA, Ouriel K, Green RM. Popliteal artery aneurysms: a 25-year surgical experience. J Vasc Surg. 1991;14:771–6; discussion 776–9.

    Google Scholar 

  17. Galland RB. Popliteal aneurysms: controversies in their management. Am J Surg. 2005;190:314–8.

    Article  PubMed  CAS  Google Scholar 

  18. Taurino M, Calisti A, Grossi R, Maggiore C, Speziale F, Fiorani P. Outcome of early treatment of popliteal artery aneurysms. Int Angiol. 1998;17:28–33.

    PubMed  CAS  Google Scholar 

  19. Steinmetz E, Bouchot O, Faroy F, Charmasson L, Terriat B, Becker F, et al. Preoperative intraarterial thrombolysis before surgical revascularization for popliteal artery aneurysm with acute ischemia. Ann Vasc Surg. 2000;14:360–4.

    Article  PubMed  CAS  Google Scholar 

  20. Aulivola B, Hamdan AD, Hile CN, Sheahan MG, Skillman JJ, Campbell DR, et al. Popliteal artery aneurysms: a comparison of outcomes in elective versus emergent repair. J Vasc Surg. 2004;39:1171–7.

    Article  PubMed  Google Scholar 

  21. Galland RB. History of the management of popliteal artery aneurysms. Eur J Vasc Endovasc Surg. 2008;35:466–72.

    Article  PubMed  CAS  Google Scholar 

  22. Mahmood A, Salaman R, Sintler M, Smith SRG, Simms MH, Vohra RK. Surgery of popliteal artery aneurysms: a 12 year experience. J Vasc Surg. 2003;37:586–93.

    Article  PubMed  Google Scholar 

  23. Beseth BD, Moore WS. The posterior approach for repair of popliteal artery aneurysms. J Vasc Surg. 2006;43:940–4; discussion 944–5.

    Google Scholar 

  24. Reilly MK, Abbott WM, Darling MC. Aggressive surgical management of popliteal aneurysms. Am J Surg. 1983;145:498–502.

    Article  PubMed  CAS  Google Scholar 

  25. Kirkpatrick UJ, Williams RG, Martin J, Brennan JA, Gilling-Smith GL, Harris PL. Late complications after ligation and bypass for popliteal aneurysm. Br J Surgery. 2004;81:174–7.

    Article  Google Scholar 

  26. Mehta M, Champagne B, Darling RC III, Roddy SP, Kreienberg PB, Ozsvath KJ, et al. Outcome of popliteal artery aneurysms after exclusion and bypass: significance of residual patent branches mimicking type II endoleaks. J Vasc Surg. 2004;40:886–90.

    Article  PubMed  Google Scholar 

  27. Marin ML, Veith FJ, Panetta TF, Cynamon J, Bakal CW, Suggs WD, et al. Transfemoral endoluminal stented graft repair of a popliteal artery aneurysm. J Vasc Surg. 1994;19:754–7.

    Article  PubMed  CAS  Google Scholar 

  28. Tielliu IF, Verhoeven EL, Prins TR, Post WJ, Hulsebos RG, van den Dungen JJ. Treatment of popliteal artery aneurysms with the Hemobahn stent-graft. J Endovasc Ther. 2003;10:111–6.

    Article  PubMed  Google Scholar 

  29. Moore RD, Hill AB. Open versus endovascular repair of popliteal artery aneurysms. J Vasc Surg. 2010;51:271–6.

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors declare that there are no actual or potential conflicts of interest in relation to this article.

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Authors and Affiliations

  1. Department of Vascular Surgery, University of Rome- Sapienza, Rome, Italy

    M. Taurino, F. Filippi, R. Ficarelli, C. Fantozzi, R. Dito & L. Rizzo

  2. Department of Anesthesiology, University of Rome- Sapienza, Rome, Italy

    D. Brancadoro

Authors
  1. M. Taurino
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  2. F. Filippi
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  3. R. Ficarelli
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  4. C. Fantozzi
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  5. R. Dito
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  7. L. Rizzo
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Correspondence to R. Ficarelli.

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Taurino, M., Filippi, F., Ficarelli, R. et al. Different approaches in popliteal artery aneurysm management. Eur Surg 45, 221–226 (2013). https://doi.org/10.1007/s10353-013-0221-0

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  • DOI: https://doi.org/10.1007/s10353-013-0221-0

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