Durability of open popliteal artery aneurysm repair

Abstract

Objective: The objective of this study was to analyze our long-term results after open surgery for popliteal artery aneurysm.

Methods: Records of patients who received surgery between 1998 and 2010 were retrieved from a computerized database and analyzed retrospectively. End points of the study were perioperative mortality and morbidity and patency and limb salvage rate.

Results: Two hundred and six popliteal aneurysms (median diameter, 30 mm; interquartile range, 18 mm) were treated (161 elective, 45 emergent) in 154 patients (mean age, 67 ± 11 years) using vein grafts (82%) via the medial approach (92%). Above-knee popliteal artery (45%) and below-knee popliteal artery (65%) were the predominant inflow and outflow vessels. The overall surgical mortality was 2% (2% for elective and 3% for emergent procedures; P = not significant). Primary, assisted primary, and secondary patency rates were 88.1% (73.5%), 92.1% (84.3%), and 96.5% (89.8%) at 5 (at 10) years, respectively, with no significant difference between elective and emergent surgeries. Limb salvage rate was significantly reduced in the emergent group vs the elective group with 91.1% vs 98.6% at 5 and 10 years (P = .0049). The rate of freedom from any reintervention was 84.3% at 5 and 69.8% at 10 years, respectively.

Conclusions: Open surgery for popliteal artery aneurysm is marked by low perioperative mortality and morbidity and provides excellent long-term results.