Open versus endovascular repair of popliteal artery aneurysms

Abstract

A 72-year-old male presents with a large asymptomatic aneurysm of his left popliteal artery. He has a history of noninsulin dependent diabetes, hypertension, and a prior history of a percutaneous intervention for a coronary artery stenosis. He is anatomically and physiologically a candidate for surgical or endovascular repair of his aneurysm. The following debate attempts to resolve whether open repair remains the gold standard for the treatment of popliteal artery aneurysms.

Durability of open popliteal artery aneurysm repair

“…11 With regard to perioperative morbidity, it has been stressed that open surgery is endowed with specific complications such as surgical site infections and hematoma. 20 In our series, the overall rate of hematoma was 8%, again being comparable with other studies. 19 The overall rate of fasciotomies was 5%, and was significantly greater in the emergent group (16%; P ¼ .0005).…”

Repair of popliteal aneurysm and spontaneous arteriovenous fistula in a patient with Marfan syndrome

“…Repair of popliteal aneurysms may be undertaken with an open surgical or endovascular approach, 13 with Fig 1. A, Volume-rendered reconstruction of computed tomography angiograms of the abdomen, pelvis, and lower extremities shows a hypertrophied superficial femoral artery (arrow) remains enlarged into the proximal popliteal artery where an arteriovenous fistula (AVF) is suspected, given the dilated deep venous system and rapid transit of contrast to the inferior vena cava (arrowhead). B, Localized volume-rendered reconstruction focused on the popliteal artery (arrow) demonstrates a direct AVF to the popliteal vein (arrowhead), with a normally sized distal popliteal artery below the fistula.…”

One-Stage Hybrid Repair of Multiple Degenerative Aneurysms

“…Although the indications for repair of PAAs are not well defined, a diameter greater than 2 cm to 3 cm, especially for aneurysms with a significant thrombus load or with chronic distal tibial artery embolic occlusion, is an acceptable indication for intervention [11]. Nevertheless, the optimal treatment approach remains a matter of debate.…”