Small popliteal artery aneurysms: Are they clinically significant?

Ascher, Enrico; Markevich, Natalia; Schutzer, Richard; Kallakuri, Sreedhar; Jacob, Theresa; Hingorani, Anil

doi:10.1067/mva.2003.232

Cited by 89 publications

(49 citation statements)

References 12 publications

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“…3,5,[7][8][9][10][11][12][13][14][15]20,24,[26][27][28][31][32][33][34][35][36][37] In the majority of patients, the endovascular repair was done in the presence of a good tibial run-off; at least two patent tibial arteries were present in 71% (95% CI 65%-76%) of patients. 1,7,10,[12][13][14][15]24,27,32,33,35,38 Several types of stents have been used to treat PAA. At the beginning of the era of this new modality of treatment, in North America home-made devices made of balloon expandable stents covered with vein or PTFE were used, while in Europe the Cragg Endo Pro stents were used, which included the System 1 (a self expandable nitinol stent covered by polyester fabric, Cragg EndoPro System; Mintec, La Ciotat, France); the Passager stent graft (a self expandable, polyester-covered metal stent-grafts; Boston Scientific, Watertown, Mass), and the Corvita stentgraft (a metallic self-expandable, braided wire stent to which is bonded an inner liner of polycarbonate urethane microfibers; Boston Scientific, Bülach, Switzerland).…”

Section: Resultsmentioning

confidence: 99%

Endovascular repair of popliteal aneurysms

Cinà

2010

Journal of Vascular Surgery

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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.

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Section: Resultsmentioning

confidence: 99%

Endovascular repair of popliteal aneurysms

Cinà

2010

Journal of Vascular Surgery

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“…However, we have reported the incidence of thrombosis even in smaller aneurysms. 9 Ramesh et al 10 observed distortion of the aneurysm as a sensitive predictor of thrombosis in PAA rather than the size alone. These authors proposed aneurysms with a combination of distortion, and size of more than 3 cm are more likely to undergo thrombosis.…”

Section: Discussionmentioning

confidence: 98%

Effect of Duplex Arteriography in the Management of Acute Limb-Threatening Ischemia From Thrombosed Popliteal Aneurysms

Kallakuri¹,

Ascher²,

Hingorani³

et al. 2008

Angiology

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The role of routine use of duplex arteriography to diagnose thrombosis of popliteal artery aneurysm as a cause of acute lower extremity ischemia is investigated. In all, 109 patients (group 1) from 1994 to 1997 and 201 patients from 1998 to 2001(group 2) presenting with acute limb-threatening ischemia were studied. None of the group 1 patients underwent preoperative duplex arteriography, and no diagnosis of acute popliteal artery aneurysm thrombosis was made. Ten patients with acute ischemia due to thrombosed popliteal artery aneurysm were identified in group 2 when preoperative duplex arteriography was routinely performed. Urgent revascularization was performed based on the results of duplex arteriography. Six patients had functioning bypasses with a mean follow-up of 15.6 months. There were 3 deaths, 2 within 30 days and 1 after 2(1/2) years with functioning grafts. One patient was lost to follow-up. Routine use of duplex arteriography may provide the diagnosis and may identify the available outflow vessels for popliteal artery aneurysm.

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“…On the other hand, we have reported the incidence of thrombosis even in smaller aneurysms. 9 Ramesh et al 10 observed distortion of the aneurysm as a more sensitive predictor of thrombosis in PAA than size alone. These authors proposed that aneurysms with a combination of distortion and size of more than 3 cm are more likely to undergo thrombosis.…”

Section: Discussionmentioning

confidence: 98%

Impact of Duplex Arteriography in the Evaluation of Acute Lower Limb Ischemia from Thrombosed Popliteal Aneurysms

Kallakuri¹,

Ascher²,

Hingorani³

et al. 2006

Vasc Endovascular Surg

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Acute limb-threatening ischemia from thrombosis may be the initial presentation of popliteal artery aneurysms (PAA) and is associated with amputation rates of 20-30%. Since contrast angiography may miss the diagnosis, the authors suspect that thrombosis of PAA may be an underappreciated cause of acute ischemia. Routine use of duplex arteriography (DA) may aid in the diagnosis and may help identify the outflow vessels with improved results. One hundred and nine patients (group 1) from 1994 to 1997 and 201 patients from 1998 to 2001 (group 2) presenting with acute limb-threatening ischemia were studied. None of the group 1 patients underwent preoperative DA and no diagnosis of acute popliteal artery aneurysm thrombosis was made. Ten patients with acute ischemia due to thrombosed popliteal artery aneurysms were identified in group 2 when preoperative DA was routinely performed. Urgent revascularization based on the results from DA was performed with use of autogenous saphenous vein in all patients. Six patients had functioning bypasses with a mean follow-up of 15.6 months. There were 3 deaths, 2 within 30 days and 1 after 2(1/2) years with functioning grafts. One patient was lost to follow-up. No major amputations were performed. Incidence of thrombosed popliteal artery aneurysms as the cause of acute limb-threatening ischemia is probably underestimated. Routine use of DA may provide the diagnosis and identifies the available outflow vessels. Contrary to previously published reports, urgent revascularization of an acutely ischemic extremity from thrombosed popliteal aneurysm can provide excellent rates of limb salvage.

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Small popliteal artery aneurysms: Are they clinically significant?

Cited by 89 publications

References 12 publications

Endovascular repair of popliteal aneurysms

Endovascular repair of popliteal aneurysms

Effect of Duplex Arteriography in the Management of Acute Limb-Threatening Ischemia From Thrombosed Popliteal Aneurysms

Impact of Duplex Arteriography in the Evaluation of Acute Lower Limb Ischemia from Thrombosed Popliteal Aneurysms

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