1
|
Giardini M, Binkert CA, Wyss TR. Residual Popliteal Aneurysm Perfusion Leading to Embolic Complications: A Case Report. EJVES Vasc Forum 2024; 62:1-4. [PMID: 38974217 PMCID: PMC11225015 DOI: 10.1016/j.ejvsvf.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/03/2024] [Accepted: 05/15/2024] [Indexed: 07/09/2024] Open
Abstract
Introduction Surgical management of popliteal artery aneurysms has been described for half a century. Long term development of the excluded aneurysm sac in the popliteal segment however remains widely unknown, with only a few small series describing outcomes. Residual aneurysm perfusion has the potential to lead to serious complications. Report A 63 year old man presents with skin and soft tissue necrosis of the right calf two years after proximal and distal aneurysm ligation and great saphenous vein bypass for a popliteal artery aneurysm. Computed tomography and magnetic resonance angiography show perfusion of the excluded aneurysm as well as extensive necrosis of the gastrocnemius muscle. Direct angiography of the aneurysm demonstrated retrograde aneurysm perfusion due to insufficient distal ligation with recurrent micro-embolisation to the calf via geniculate arteries. Coiling of the geniculate arteries was performed, plugging the connection to the tibiofibular trunk and embolisation of the aneurysm sac. After the intervention, no flow was seen in the aneurysm sac and the patient made full recovery. Discussion Residual aneurysm sac perfusion can lead to complications long after successful aneurysm exclusion. Follow-up after surgery of popliteal aneurysms should include observation of the excluded aneurysm sac with control of residual blood flow. For persistent sac perfusion, aneurysm enlargement or symptoms, further treatment should be considered. Surgical aspects such as complete transection of the artery after aneurysm ligation or end to end anastomosis of the bypass may be considered, to prevent such complications.
Collapse
Affiliation(s)
- Matteo Giardini
- Department of Interventional Radiology and Vascular Surgery, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Christoph A. Binkert
- Department of Interventional Radiology and Vascular Surgery, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Thomas R. Wyss
- Department of Interventional Radiology and Vascular Surgery, Kantonsspital Winterthur, Winterthur, Switzerland
- Department of Vascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| |
Collapse
|
2
|
Dowling C, Whitaker L, Dietzek A. Repair of a giant, recurrent popliteal artery aneurysm. J Vasc Surg 2024:S0741-5214(24)00427-0. [PMID: 38462059 DOI: 10.1016/j.jvs.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 03/12/2024]
Affiliation(s)
- Caitlin Dowling
- Department of Surgery, Division of Vascular Surgery, Long Island Jewish Medical Center, Queens, NY
| | - Litton Whitaker
- Department of Surgery, Division of Vascular Surgery, Danbury Hospital, Danbury, CT
| | - Alan Dietzek
- Department of Surgery, Division of Vascular Surgery, Danbury Hospital, Danbury, CT.
| |
Collapse
|
3
|
Wrede A, Acosta S, Lehti L, Lorenzen US, Zielinski AH, Eiberg JP. Endoleak following endovascular repair of popliteal artery aneurysm: clinical outcome and contrast-enhanced ultrasound detection. INT ANGIOL 2023; 42:26-32. [PMID: 36751984 DOI: 10.23736/s0392-9590.22.04983-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Continued blood flow in the aneurysm sac after repair, also known as endoleak, can occur after both open and endovascular popliteal aneurysm repair (EPAR) with risk for aneurysm sac enlargement. Primary aims were to investigate aneurysm sac growth and the presence and classification of endoleak after EPAR using contrast-enhanced ultrasound (CEUS). METHODS Cross-sectional study of patients receiving EPAR with expanded polytetrafluorethylene (ePTFE) covered stent-grafts between 1st of January 2009 and 1st of February 2019 at a tertiary referral endovascular center. Patients were re-invited in 2021 and 31 legs were examined for endoleak using CEUS. Endoleaks were classified by a core-lab consisting of three CEUS-experienced physicians. RESULTS Median follow-up was 57 months (range 33-143 months). Endoleak was detected in 16 PAA, and categorized as type I (N.=3), type II (N.=10), type III (N.=1) or indeterminate (N.=2). Median maximal PAA diameter was 24 mm (range 15-55 mm) at the time of EPAR compared to 17 mm (range 6-43 mm) at follow-up (P<.001). Maximal aneurysm sac diameter was smaller at follow-up than at the index procedure in both PAAs with and without endoleak on CEUS (P=0.005 vs. P<0.001, respectively). There was no difference in PAA sac shrinkage at follow-up between patients with or without endoleak (P=0.28). Freedom from aneurysm sac growth was 97%. CONCLUSIONS CEUS was sensitive in endoleak detection after EPAR. Shrinkage of the PAA sac was found in both patients with and without endoleaks. CEUS appears useful for targeted examinations rather than routine surveillance after EPAR.
Collapse
Affiliation(s)
- Axel Wrede
- Department of Clinical Sciences, Lund University, Malmö, Sweden -
| | - Stefan Acosta
- Department of Clinical Sciences, Lund University, Malmö, Sweden.,Vascular Center, Department of Cardio-Thoracic and Vascular Surgery, Skane University Hospital, Malmö, Sweden
| | - Leena Lehti
- Department of Clinical Sciences, Lund University, Malmö, Sweden.,Vascular Center, Department of Cardio-Thoracic and Vascular Surgery, Skane University Hospital, Malmö, Sweden
| | - Ulver S Lorenzen
- Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark.,University of Copenhagen, Copenhagen, Denmark
| | - Alexander H Zielinski
- Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark.,University of Copenhagen, Copenhagen, Denmark
| | - Jonas P Eiberg
- Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark.,University of Copenhagen, Copenhagen, Denmark.,Copenhagen Academy for Medical Education and Simulation (CAMES), Copenhagen, Denmark
| |
Collapse
|
4
|
Troisi N, Masciello F, Michelagnoli S, Chisci E. Outcomes of popliteal artery aneurysms treated by ligation and in situ saphenous vein bypass. INT ANGIOL 2021; 40:435-441. [PMID: 34142541 DOI: 10.23736/s0392-9590.21.04708-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Modality of elective repair (open or endovascular) of popliteal artery aneurysms (PAAs) is still debated. About open repair no strict evidence exists about the best surgical technique. The aim of this study was to report a 20-year experience with ligation and in situ saphenous vein bypass for the elective treatment of PAAs. METHODS A retrospective review of consecutive patients who underwent elective open surgical PAA repair in our center between January 2001 and April 2020 was performed. Ninety-two limbs in 84 patients underwent a PAA ligation and in situ saphenous bypass. Early (30 day) outcomes were assessed. Estimated 5-year outcomes according to Kaplan-Meier curves in terms of primary patency, primary assisted patency, secondary patency, and limb salvage were evaluated. Associations of patient and procedure variables with patency and limb salvage outcomes were sought with multivariate analysis. RESULTS Patients were predominantly male (80/84, 95.2%) with a mean age of 73.1 years (range 50-89). In all cases technical success was obtained. The mean hospital stay was 5.8 days (range 2-27). Thirty-day overall mortality (n=1) and major amputation (n=1) rates were both 1.2%. Mean duration of follow-up was 31.3 months (range 1-168). At 5 years estimated rates of primary patency, primary assisted patency, secondary patency, and limb salvage were 76.3%, 81.5%, 89.9%, and 96.6%, respectively. On multivariate analysis the associations were: primary patency with PAA diameter >30 mm (P=.007), and poor run-off status (P<.001); primary assisted patency with poor run-off status (P<.001); secondary patency with poor run-off status (P=.04). Major amputation had no independent predictors of poor outcomes. CONCLUSIONS Elective surgical treatment of PAAs with ligation and in situ saphenous vein bypass is safe, effective and urable with good 5-year outcomes in terms of overall patency and limb salvage. Poor run-off status seemed to be an independent predictor of worse patency rates. This surgical technique should be cautiously applied in patients with PAAs with a diameter >30 mm.
Collapse
Affiliation(s)
- Nicola Troisi
- Vascular and Endovascular Surgery Unit, Department of Surgery, San Giovanni di Dio Hospital, Florence, Italy -
| | - Fabrizio Masciello
- Vascular and Endovascular Surgery Unit, Department of Surgery, San Giovanni di Dio Hospital, Florence, Italy
| | - Stefano Michelagnoli
- Vascular and Endovascular Surgery Unit, Department of Surgery, San Giovanni di Dio Hospital, Florence, Italy
| | - Emiliano Chisci
- Vascular and Endovascular Surgery Unit, Department of Surgery, San Giovanni di Dio Hospital, Florence, Italy
| |
Collapse
|
5
|
Farber A, Angle N, Avgerinos E, Dubois L, Eslami M, Geraghty P, Haurani M, Jim J, Ketteler E, Pulli R, Siracuse JJ, Murad MH. The Society for Vascular Surgery clinical practice guidelines on popliteal artery aneurysms. J Vasc Surg 2021; 75:109S-120S. [PMID: 34023430 DOI: 10.1016/j.jvs.2021.04.040] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 04/03/2021] [Indexed: 10/21/2022]
Abstract
The Society for Vascular Surgery clinical practice guidelines on popliteal artery aneurysms (PAAs) leverage the work of a panel of experts chosen by the Society for Vascular Surgery to review the current world literature as it applies to PAAs to extract the most salient, evidence-based recommendations for the treatment of these patients. These guidelines focus on PAA screening, indications for intervention, choice of repair strategy, management of asymptomatic and symptomatic PAAs (including those presenting with acute limb ischemia), and follow-up of both untreated and treated PAAs. They offer long-awaited evidence-based recommendations for physicians taking care of these patients.
Collapse
Affiliation(s)
- Alik Farber
- Boston Medical Center, Boston University School of Medicine, Boston, Mass.
| | | | - Efthymios Avgerinos
- Clinic of Vascular and Endovascular Surgery, Athens Medical Group, University of Athens, Athens, Greece
| | - Luc Dubois
- London Health Sciences Center, Western University, London, Ontario, Canada
| | - Mohammad Eslami
- University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pa
| | | | - Mounir Haurani
- The Ohio State University Medical Center, Columbus, Ohio
| | - Jeffrey Jim
- Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minn
| | - Erika Ketteler
- New Mexico Veterans Affairs Health Care System, Albuquerque, NM
| | | | - Jeffrey J Siracuse
- Boston Medical Center, Boston University School of Medicine, Boston, Mass
| | - M Hassan Murad
- Evidence-Based Practice Center, Mayo Clinic, Rochester, Minn
| |
Collapse
|
6
|
Chapman SC, Al-Khoury G, Leers SA. Endovascular approach to arterial branches mimicking a type II endoleak after popliteal artery aneurysm exclusion and bypass. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2020; 6:659-663. [PMID: 33251392 PMCID: PMC7683216 DOI: 10.1016/j.jvscit.2020.08.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/15/2020] [Indexed: 11/16/2022]
Abstract
The management of popliteal artery aneurysms (PAAs) has continued to evolve. Open surgical treatment remains an excellent option. Aneurysm exclusion with saphenous vein bypass through a medial incision remains a preferred approach. After PAA exclusion, however, a possibility remains of sac expansion from geniculate arterial branches. This can mimic a type II endoleak occurring after endovascular aortic aneurysm repair. In the present report, we have described an endovascular technique used to treat an enlarging PAA after exclusion and bypass.
Collapse
Affiliation(s)
- Scott C Chapman
- Department of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Georges Al-Khoury
- Department of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Steven A Leers
- Department of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa
| |
Collapse
|
7
|
Suprageniculate Approach to Release of Popliteal Entrapment without Distal Bypass Despite Preoperative Runoff Thrombosis. Ann Vasc Surg 2017; 46:206.e5-206.e10. [PMID: 28739462 DOI: 10.1016/j.avsg.2017.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 07/17/2017] [Accepted: 07/18/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Popliteal artery entrapment syndrome is an uncommon condition in which anatomic or functional popliteal artery compression causes arterial insufficiency. We present a case of popliteal entrapment with runoff thrombosis treated with suprageniculate release of entrapment without distal bypass. RESULTS A 15-year old boy with Klinefelter syndrome presented with right leg claudication severely limiting his activity. He had a palpable femoral pulse, but no palpable popliteal or foot pulses on the right. Noninvasive testing showed a partially thrombosed popliteal artery with an ankle-brachial index (ABI) of 0.69. Computed tomography scan revealed type III popliteal entrapment with distal thromboses and abnormal insertion of gastrocnemius muscle. Popliteal entrapment release was performed via a medial suprageniculate approach in consideration for distal bypass. The soleus was released first; intraoperative angiography showed continued popliteal compression with forced dorsiflexion. This was followed by release of the gastrocnemius and found caudal and medial to the soleus as a tight band. Repeat angiography showed cessation of popliteal artery compression with dorsiflexion. Bypass was not performed due to improvement of distal flow seen on angiography. Postoperative recovery was unremarkable. On 1-month and 9-month follow-up, he had a normal ABI and arterial duplex, was asymptomatic, and had returned to normal activities. CONCLUSIONS We describe suprageniculate approach to popliteal release that may be useful if a distal bypass is planned. In this case, bypass was unnecessary despite the abnormal appearance of distal runoff on preoperative imaging, as the child's perfusion improved with entrapment release alone, and arterial remodeling over time resulted in normal perfusion and arterial appearance on duplex imaging.
Collapse
|
8
|
Mazzaccaro D, Carmo M, Dallatana R, Settembrini AM, Barbetta I, Tassinari L, Roveri S, Settembrini PG. Comparison of posterior and medial approaches for popliteal artery aneurysms. J Vasc Surg 2015; 62:1512-20. [DOI: 10.1016/j.jvs.2015.06.227] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 06/29/2015] [Indexed: 10/23/2022]
|
9
|
Dorigo W, Pulli R, Alessi Innocenti A, Azas L, Fargion A, Chiti E, Matticari S, Pratesi C. A 33-year experience with surgical management of popliteal artery aneurysms. J Vasc Surg 2015; 62:1176-82. [DOI: 10.1016/j.jvs.2015.06.216] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 06/17/2015] [Indexed: 10/23/2022]
|
10
|
Comparison of popliteal artery aneurysm therapies. J Vasc Surg 2015; 61:655-61. [DOI: 10.1016/j.jvs.2014.10.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 10/05/2014] [Indexed: 11/22/2022]
|
11
|
Wagenhäuser MU, Herma KB, Sagban TA, Dueppers P, Schelzig H, Duran M. Long-term results of open repair of popliteal artery aneurysm. Ann Med Surg (Lond) 2015; 4:58-63. [PMID: 25905015 PMCID: PMC4405004 DOI: 10.1016/j.amsu.2015.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 01/27/2015] [Accepted: 01/31/2015] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION Popliteal artery aneurysms (PAA) are rare. Different surgical techniques for open surgical repair are possible. This study presents a single centre experience using open surgical repair with a medial approach (MA) and outlines differences between symptomatic (SLS) and asymptomatic (ALS) legs. METHODS Data collection was performed retrospectively. The investigation period was from 1 January 1996 to 1 January 2013. Patients presented in the Outpatient Department and received a questionnaire concerning their quality of life. Data are presented as mean ± standard deviation. Mann-Whitney test and Cochran-Armitage test for trend was used for data analysis. Kaplan-Meier method was used to calculate limb salvage rates. p < 0.05 was considered statistically significant. RESULTS We analyzed 16 ALS and 26 SLS with an average age of 63.5 ± 10 years. Preoperative ankle-brachial index (ABI) was 1.0 ± 0.2 for ALS (on control examination: 1.12 ± 0.24) and 0.08 ± 0.18 for SLS (on control examination 0.94 ± 0.14) (p < 0.05). Limb salvage rate was 100% for ALS and 86.7% for SLS (overall 93.3%). Primary patency rate for SLS was 85%, for ALS rate of 100%, respectively (overall 92.5%). ALS reached an average of 13.1 ± 2.7 points (SLS 11.4 ± 2.8) on a numeric point scale. CONCLUSION Open surgery is therapy and prevention of acute ischaemia all in one, especially for asymptomatic patients and delivers good long-term results. Endovascular therapies offer an alternative but long-term results are pending. Open surgery should still be considered as a gold standard therapy.
Collapse
Affiliation(s)
- M U Wagenhäuser
- Department of Vascular and Endovascular Surgery, University Hospital Düsseldorf, Germany, Moorenstraße. 5, 40225 Düsseldorf, Germany
| | - K B Herma
- Department of Vascular and Endovascular Surgery, University Hospital Düsseldorf, Germany, Moorenstraße. 5, 40225 Düsseldorf, Germany
| | - T A Sagban
- Department of Vascular and Endovascular Surgery, University Hospital Düsseldorf, Germany, Moorenstraße. 5, 40225 Düsseldorf, Germany
| | - P Dueppers
- Department of Vascular and Endovascular Surgery, University Hospital Düsseldorf, Germany, Moorenstraße. 5, 40225 Düsseldorf, Germany
| | - H Schelzig
- Department of Vascular and Endovascular Surgery, University Hospital Düsseldorf, Germany, Moorenstraße. 5, 40225 Düsseldorf, Germany
| | - M Duran
- Department of Vascular and Endovascular Surgery, University Hospital Düsseldorf, Germany, Moorenstraße. 5, 40225 Düsseldorf, Germany
| |
Collapse
|
12
|
Dorweiler B, Gemechu A, Doemland M, Neufang A, Espinola-Klein C, Vahl CF. Durability of open popliteal artery aneurysm repair. J Vasc Surg 2014; 60:951-7. [DOI: 10.1016/j.jvs.2014.04.035] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 04/10/2014] [Indexed: 11/26/2022]
|
13
|
|
14
|
Hogendoorn W, Schlösser FJ, Moll FL, Muhs BE, Hunink MM, Sumpio BE. Decision analysis model of open repair versus endovascular treatment in patients with asymptomatic popliteal artery aneurysms. J Vasc Surg 2014; 59:651-62. [DOI: 10.1016/j.jvs.2013.09.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 09/06/2013] [Accepted: 09/13/2013] [Indexed: 10/26/2022]
|
15
|
Long-term Outcome of Endovascular Repair of Popliteal Artery Aneurysm Presents a Credible Alternative to Open Surgery. Cardiovasc Intervent Radiol 2013; 37:914-9. [DOI: 10.1007/s00270-013-0744-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 08/19/2013] [Indexed: 11/25/2022]
|
16
|
Abstract
Aneurysms of the popliteal artery are the most common form of peripheral aneurysm with an incidence of 70-80 %. An enlargement of the popliteal artery of more than 50% of the original diameter is defined as a popliteal artery aneurysm and is found mainly in male patients older than 65 years of age. The incidence is 1%, in 50% of cases is bilateral and in up to 50% in association with other large vessel aneurysms (e.g. abdominal aorta). Differential diagnoses are Baker's cyst, cystic adventitial disease, entrapment syndrome and epitheloid hemangioma. One third of all diagnosed popliteal artery aneurysms are asymptomatic incidental findings, whereas two thirds are conspicuous due to symptoms (acute or chronic ischemia, local compression, rupture). The indications for invasive treatment are given for patients with patent aneurysms at a diameter of more than 2 cm or if a thrombus is present within the aneurysm. Symptomatic popliteal artery aneurysms are always an indication for therapy. Treatment strategies are surgical techniques and endovascular interventions, which both have a similar outcome and graft patency in midterm results.
Collapse
Affiliation(s)
- R Ghotbi
- Gefäßchirurgische Klinik, Klinikum München Pasing, Lehrkrankenhaus LMU, München, Deutschland.
| | | |
Collapse
|
17
|
Tsilimparis N, Dayama A, Ricotta JJ. Open and Endovascular Repair of Popliteal Artery Aneurysms: Tabular Review of the Literature. Ann Vasc Surg 2013; 27:259-65. [DOI: 10.1016/j.avsg.2012.01.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 01/23/2012] [Indexed: 11/17/2022]
|
18
|
|
19
|
Guzzardi G, Fossaceca R, Cerini P, Di Terlizzi M, Stanca C, Di Gesù I, Martino F, Brustia P, Carriero A. Endovascular treatment of popliteal artery aneurysms: preliminary results. Radiol Med 2012; 118:229-38. [DOI: 10.1007/s11547-012-0839-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Accepted: 09/07/2011] [Indexed: 10/28/2022]
|
20
|
|
21
|
Inflammatory Popliteal Aneurysm. Ann Vasc Surg 2011; 25:698.e13-6. [DOI: 10.1016/j.avsg.2010.12.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Revised: 10/21/2010] [Accepted: 12/06/2010] [Indexed: 11/23/2022]
|
22
|
Funk LM, Robinson WP, Menard MT. Surgical Treatment of an Infected Popliteal Artery Aneurysm 12 Years after Aneurysm Exclusion and Bypass. Ann Vasc Surg 2010; 24:553.e9-553.e11. [DOI: 10.1016/j.avsg.2009.09.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Accepted: 09/01/2009] [Indexed: 10/19/2022]
|
23
|
Eligibility for Endovascular Technique and Results of the Surgical Approach to Popliteal Artery Aneurysms at a Single Center. Ann Vasc Surg 2010; 24:342-8. [DOI: 10.1016/j.avsg.2009.08.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Revised: 08/25/2009] [Accepted: 08/26/2009] [Indexed: 11/22/2022]
|
24
|
Bisdas T, Paraskevas KI, Pichlmaier M, Wilhelmi M, Haverich A, Teebken OE. Dorsal (Posterior) Versus Medial Approach for the Surgical Repair of Popliteal Artery Aneurysms. Angiology 2010; 61:248-52. [DOI: 10.1177/0003319709355802] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The surgical approach-of-choice for the management of popliteal artery aneurysms (PAAs) remains controversial. We compared the results of the medial (MA) and dorsal (posterior) surgical approach (DA). Fifty patients (44 males/6 females; median age [range]: 59 [49-84] years) treated for 58 atherosclerotic PAAs were studied (MA: 29 PAAs; DA: 29 PAAs). The 3-year graft patency rates were higher after DA compared with MA (76% vs 52%, respectively), but the difference was not significant (P = .056). There were no differences between the 2 approaches in amputation, restenosis, reoperation, and wound infection rates. Dorsal approach and the MA may be alternative approaches with similar long-term results. Due to the controversial results reported so far, a meta-analysis may be necessary to establish the surgical approach-of-choice. Future studies should take into account additional factors, other than the surgical technique, when assessing outcome (eg, preoperative statin use, age, and emergency vs routine surgery).
Collapse
Affiliation(s)
- Theodosios Bisdas
- Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | | | - Maximilian Pichlmaier
- Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Matthias Wilhelmi
- Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Axel Haverich
- Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Omke Enno Teebken
- Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| |
Collapse
|
25
|
Open versus endovascular repair of popliteal artery aneurysms. J Vasc Surg 2010; 51:271-6. [PMID: 20117505 DOI: 10.1016/j.jvs.2009.09.060] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Revised: 09/14/2009] [Accepted: 09/15/2009] [Indexed: 11/24/2022]
|
26
|
Mukherjee D, Tallant T. Popliteal artery aneurysm repair as an outpatient. Vascular 2009; 17:210-2. [PMID: 19698301 DOI: 10.2310/6670.2008.00077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
With the advent of endovascular repair of aneurysmal disease, length of hospital stay is becoming shorter. Inherent morbidity and problems associated with open repair have been minimized, leading to an improved patient experience. We describe a fairly typical patient with a popliteal artery aneurysm who would be expected to have a protracted recovery from open resection but instead underwent endovascular repair as an outpatient.
Collapse
Affiliation(s)
- Dipankar Mukherjee
- Cardiac, Vascular & Thoracic Surgery Associates, Falls Church, VA 22042, USA.
| | | |
Collapse
|
27
|
Robinson WP, Belkin M. Acute Limb Ischemia Due to Popliteal Artery Aneurysm: A Continuing Surgical Challenge. Semin Vasc Surg 2009; 22:17-24. [PMID: 19298931 DOI: 10.1053/j.semvascsurg.2008.12.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
28
|
de Koning HD, Zeebregts CJ, Reijnen MMPJ. Hybrid treatment of a symptomatic popliteal pseudoaneurysm due to type-I endoleak after previous endovascular exclusion. Catheter Cardiovasc Interv 2008; 71:983-6. [PMID: 18324701 DOI: 10.1002/ccd.21471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE The development of endovascular repair of popliteal aneurysms has provided an alternative, minimally invasive way of treatment. We present a case of a late type-I endoleak, after previous exclusion of a popliteal pseudoaneurysm, leading to rupture and massive hematoma, which was excluded in a hybrid procedure. CASE REPORT A 95-year-old woman presented with progressive swelling with skin ulceration and necrosis cranial to the medial side of her left knee. Four years earlier, a left popliteal pseudoaneurysm was excluded with a stent-graft. Rupture of the popliteal artery with massive hematoma was demonstrated by ultrasound examination and a spiral computed tomography scan, with high suspicion of a type-I endoleak. Endovascular repair of the endoleak with a polytetrafluoroethylene-covered stent-graft was followed by surgical resection of the damaged skin and evacuation of the hematoma. CONCLUSION Type-I endoleaks after endovascular exclusion of popliteal pseudoaneurysms do occur and may lead to rupture. A symptomatic pseudoaneurysm may be successfully treated by a hybrid procedure.
Collapse
Affiliation(s)
- Heleen D de Koning
- Department of Surgery (Division of Vascular Surgery), Alysis Zorggroep, Location Rijnstate, Arnhem, The Netherlands
| | | | | |
Collapse
|
29
|
Perdikides TP, Avgerinos E, Christianakis E, Fotis T, Chronopoulos A, Siafakas KX, Pashalidis N, Filippou DK. Bilateral giant femoropopliteal artery aneurysms: a case report. J Med Case Rep 2008; 2:114. [PMID: 18423052 PMCID: PMC2365963 DOI: 10.1186/1752-1947-2-114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2007] [Accepted: 04/20/2008] [Indexed: 11/26/2022] Open
Abstract
Introduction Popliteal artery aneurysms are the most common peripheral arterial aneurysms, and are frequently bilateral. Acute limb ischemia, rupture and compression phenomena can complicate these aneurysms when the diameter exceeds 2 cm. Case Presentation We report an 82-year-old male patient with two giant femoropopliteal aneurysms, 10.5 and 8.5 cm diameters, managed in our institution. Both aneurysms were resected and a polytetrafluoroethylene (PTFE) femoropopliteal interposition graft was placed successfully. Management and literature review are discussed. Conclusion We believe this is the first report in the medical literature of bilateral giant femoropopliteal aneurysms.
Collapse
Affiliation(s)
- Theodossios P Perdikides
- Department of Thoracic and Vascular Surgery, Hellenic Airforce Hospital, Galatsi, Athens, Greece.
| | | | | | | | | | | | | | | |
Collapse
|
30
|
Reijnen MMPJ, de Rhoter W, Zeebregts CJ. Treatment of a symptomatic popliteal pseudoaneurysm using a stent-graft and ultrasound-guided evacuation of the haematoma. Emerg Radiol 2008; 16:167-9. [DOI: 10.1007/s10140-008-0702-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2007] [Accepted: 01/08/2008] [Indexed: 10/22/2022]
|