Endovascular repair of popliteal aneurysms

Abstract

Endovascular repair is an established modality of treatment for abdominal aortic aneurysms. It is therefore reasonable to expect its application to other less common aneurysmal conditions, including isolated iliac and popliteal artery aneurysms (PAA). There are, however, essential differences between aortic aneurysms and peripheral aneurysms: smaller arterial caliber, mobility of the arterial segment, associated occlusive disease, and devices that have not been specifically designed for peripheral applications. Due to these differences, results obtained in abdominal aortic aneurysms cannot be extrapolated to peripheral aneurysms. The attraction of the endovascular repair for PAA is its minimally invasive nature. The literature, however, provides only case reports, case series and small cohorts, and one small randomized, controlled trial. A cumulative summary of these studies provides the clinician with information upon which to base the choice of treatment on a specific patient. Endovascular repair for PAA with suitable anatomy and good run-off can be considered safe, and medium term results appear comparable with those of open repair.

Comparison of Early and Midterm Results of Open and Endovascular Treatment of Popliteal Artery Aneurysms

“…A recent meta-analysis 25 reported an overall comparison of the endovascular versus the open intervention for 43 and 116 patients, respectively.…”

Outcome of endovascular repair of popliteal artery aneurysm using the Viabahn endoprosthesis

“…The primary and secondary patency rates were, respectively, 83% and 86% at 1 year and 74% and 85% at 3 years, and were comparable to patency achieved with open repair. 23 A further subgroup analysis of patients treated with Hemobahn/Viabahn prostheses showed improved patency compared with those treated with other stent grafts, although the results were not statistically significant. Open repair has been the standard of care for repairing PAAs for many decades, and we have identified numerous patient and technical factors contributing to successfully performed repairs.…”

Endovascular repair of multiple infrageniculate aneurysms in a patient with vascular type Ehlers-Danlos syndrome

“…Our patient had already lost ATA runoff from prior coil embolization, and coiling of her PTA aneurysm would leave her with a single vessel runoff that is potentially at risk for future aneurismal degeneration. While stent graft repair is generally accepted for popliteal aneurysms, 13 it is not well established for tibial aneurysms. Only four accounts of stent graft repair of an ATA pseudoaneurysm and one of a PTA pseudoaneurysm, all successful, have been reported in the English literature.…”