Viabahn endoprosthesis for femoropopliteal aneurysm repair: safety, success rates, and long-term patency

Abstract

Background: The Viabahn endoprosthesis has become a vital option for endovascular therapy, yet there is limited long-term data on its effectiveness for peripheral aneurysm repair. This study aimed to evaluate the safety, technical and clinical success, and long-term patency of the Viabahn endoprosthesis for treating femoropopliteal aneurysms.

Methods: This retrospective tertiary single-center study analyzed patients who underwent a Viabahn endoprosthesis procedure for femoropopliteal aneurysm repair from 2010 to 2020. Intraoperative complications, technical and clinical success rates, and major adverse events (MAE, including acute thrombotic occlusion, major amputation, myocardial infarction, and device- or procedure-related death) at 30 days were assessed. Incidence of clinically-driven target lesion revascularisation (cdTLR) was noted. Patency rates were evaluated by Kaplan-Meier analysis.

Results: Among 19 patients (mean age, 72 ± 12 years; 18 male, 1 female) who underwent aneurysm repair using the Viabahn endoprosthesis, there were no intraoperative adverse events, with 100% technical and clinical success rates. At the 30-day mark, all patients (19/19, 100%) were free of MAE. The median follow-up duration was 1,009 days [IQR, 462-1,466]. Popliteal stent graft occlusion occurred in 2/19 patients (10.5%) after 27 and 45 months, respectively. Consequently, the primary patency rates were 100%, 90%, 74% at 12, 24, and 36-72 months, respectively. Endovascular cdTLR was successful in both cases, resulting in sustained secondary patency at 100%.

Conclusion: The use of Viabahn endoprostheses for femoropopliteal aneurysm repair demonstrated technical and clinical success rates of 100%, a 0% 30-day MAE rate, and excellent long-term patency.

Keywords: Aneurysm; Endoprosthesis; Endovascular; Repair; Stent Graft; Viabahn.

Fig. 1

Viabahn endoprosthesis for endovascular treatment of popliteal aneurysm. Example of a 61-year-old man with peripheral artery disease and moderate claudication. A CT angiography (CTA) revealed a popliteal aneurysm and stent fracture in the P2 segment. B Subsequently, the patient underwent Viabahn stent graft procedure. Final target site angiography demonstrated successful aneurysm exclusion by the implanted Viabahn with preserved blood flow and no peripheral complications. C Follow-up CTA at 2 years demonstrated sustained blood flow through the device

Fig. 2

Viabahn endoprosthesis for popliteal aneurysm repair. A 73-year-old man was referred for (A) CT angiography, which revealed a popliteal aneurysm (arrows) with substantial lumen thrombus (stars). B Stent graft repair was performed using a Viabahn endoprosthesis (proximal and distal ends of the stent graft indicated by arrowheads). C Final target site angiography confirmed successful exclusion of the aneurysm and preservation of blood flow

Fig. 3

Viabahn endoprosthesis for femoral aneurysm repair. A 77-year-old man with previous P1/P3 bypass operation presented with swelling and pain in the distal posterior aspect of his thigh. A CT angiography (CTA) revealed the presence of a false aneurysm of the distal superficial femoral artery (arrow). B The patient underwent stent graft repair using a Viabahn endoprosthesis (indicated by arrowheads). The successful exclusion of the aneurysm with preservation of blood flow was confirmed by final target site angiography. C Follow-up CTA at 1 year demonstrated sustained preservation of blood flow

Fig. 4

Long-term primary patency of the Viabahn endoprosthesis for femoropopliteal aneurysm management. The curve shows the primary patency (%) of the Viabahn endoprosthesis for the treatment of femoropopliteal aneurysms over a period of 72 months following the procedure