Two Decades of Endovascular Repair of Popliteal Artery Aneurysm—A Meta-analysis

Stumm, M. von; Teufelsbauer, H.; Reichenspurner, Hermann; Debus, Eike Sebastian

doi:10.1016/j.ejvs.2015.04.036

Cited by 43 publications

(28 citation statements)

References 37 publications

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“…The six articles describing retrospective studies were published by Pulli et al, 15 Huang et al, 16 Serrano Hernando et al, 17 Ronchey et al, 18 Cervin et al, 19 and Braga et al, 13 and are summarized in Tables 1 and 2. The metanalyses used were conducted by von Stumm et al, 20 published in 2015 and combining a total of 652 cases, and by Leake et al, 21 published in 2017, covering 14 studies and 4,880 PAA treatments.…”

Section: Resultsmentioning

confidence: 99%

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Tratamento endovascular versus tratamento aberto de aneurisma de artéria poplítea: artigo de revisão

et al. 2018

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Resumo O tratamento convencional do aneurisma da artéria poplítea é a cirurgia aberta de exclusão do aneurisma e revascularização do membro acometido. Nos últimos anos, o tratamento endovascular vem ganhando popularidade e interesse. O tratamento endovascular é menos invasivo e de menor morbidade; porém, é de alto custo e sua perviedade é incerta. O objetivo desta revisão é comparar os dois tratamentos através da análise de desfechos abordados em estudos primários e secundários. Realizou-se uma revisão narrativa da literatura publicada nos últimos 5 anos. Foram selecionados seis estudos retrospectivos, duas metanálises, um ensaio clínico e uma revisão sistemática Cochrane. Número limitado de pacientes e curto período de seguimento não nos permitem extrair conclusões consistentes. Não há evidência clara que sugere melhores resultados entre um ou outro tratamento eletivo. Novos ensaios randomizados devem ser realizados para determinar o papel do tratamento endovascular desse aneurisma.

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Section: Resultsmentioning

confidence: 99%

“…In 2015, Von Stumm et al 20 published a meta-analysis analyzing one randomized controlled study, one prospective cohort study, and four retrospective cohort studies, totaling 652 cases. This meta-analysis suggests that endovascular treatment for PAA may be a safe and effective method for patients with favorable anatomy.…”

Section: Discussionmentioning

confidence: 99%

Tratamento endovascular versus tratamento aberto de aneurisma de artéria poplítea: artigo de revisão

et al. 2018

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“…Secondly, the proximal and distal neck of the aneurysm need to provide a secure site for ixation of the stent graft. Thirdly, embolisation of signi icant collateral vessels needs to prevent enlargement of the aneurysmal sac [17,[20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

“…This risk can be decreased by careful patient selection based on strict anatomic criteria and by improvement in stentgraft design and lexibility. Also migration, stenosis at the border of the stent, continuous sac enlargement and breakage of the stent material are possible complications [17,[20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

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Management of Popliteal Artery aneurysms: Experience in our center

Philippe¹

2018

Arch Vas Med

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Background: Popliteal artery aneurysms (PAAs) are rare, but the diagnosis should not be missed because of the limb and life threatening complications. The purpose of this study was to reach a consensus about the management of PAA based on our own experience and the available literature. Materials and Methods: This is a retrospective analysis of all patients who underwent an open surgical PAA repair at our institution from January 2015 to December 2016. Demographic data, risk factors, clinical presentation, aneurysm characteristics, type of repair and results were reviewed. Results include patency and major complications. Results: Seven patients underwent an open surgical PAA repair (six men). Median age was 72 years. A posterior approach (PA) was chosen four times and a medial approach (MA) was chosen three times. We performed six resections with interposition of a graft and only one ligation with a bypass. Five patients recovered well, did not develop any complication and did not need a second intervention to guarantee patency. These patients underwent a resection of the aneurysm and interposition of a graft (four via a PA and one via a MA). One patient treated by resection and interposition of a Dacron graft via a MA underwent an above-the-knee amputation at postoperative day 14. This patient had a preoperatively dysfunctional leg since several months with no patent outfl ow vessels. Our patient treated by ligation and bypass via a MA, developed an acute ischemia four months postoperatively because of an extreme fl exion of the knee during several hours while watching TV. After unsuccessful trombolysis, he underwent a femorotibial bypass and a partial forefoot amputation. No longterm results are yet available. Conclusions: In our opinion, open surgical repair of PAAs by resection of the aneurysm and interposition of a venous graft has the best results. Depending on the relation to the knee joint and thus the accessibility of the aneurysm, a posterior approach is preferred. We are not convinced of endovascular techniques in the treatment of popliteal artery aneurysms.

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