Operative repair of popliteal aneurysms: effect of factors related to the bypass procedure on outcome.
The objective of this study was to compare patency rates following the repair of popliteal aneurysms according to the site of inflow, material of bypass graft and quality of distal runoff. Seventy bypasses were performed over an 11-year period. Autogenous saphenous vein was used in 53 procedures (75.7%) and prosthetic material was used in 17 (24.3%). Early mortality was 2.8%. Early primary and secondary patency rates were 95.7% and 97.1%, respectively. Autogenous vein showed better 10-year patency than prosthetic material (86% vs. 57%; p = 0.02). No significant differences in patency were observed according to the inflow site (87.8% groin vs. 74.7% supragenicular). Bypasses that originated in the groin showed improved patency when a saphenous vein was used (84.8% vs. 43.7%; p = 0.01). However, no influence of the graft material was noted in supragenicular bypasses (90.4% vs. 84.8%; p = 0.6). Bypasses in extremities with good runoff showed better patency than those in limbs showing poor runoff (86% vs. 55%; p = 0.003). The use of saphenous vein for the repair of popliteal aneurysms showed better results than those with prosthetic material, although in bypasses originating from the distal superficial femoral or above-knee popliteal artery, no significant differences in patency were observed. Good distal runoff was associated with improved overall outcome.
Blanco
E
E
Vascular Surgery Service, Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain.
Serrano-Hernando
F J
FJ
Moñux
G
G
Vega
M
M
Martin
A
A
Rial
R
R
Reina
T
T
Sánchez-Hervas
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000601:surgery*; D001672:Biocompatible Materials / Q000627:therapeutic use; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene / Q000627:therapeutic use; D011150:Popliteal Artery / Q000601:surgery*; D012501:Saphenous Vein / Q000637:transplantation; D016896:Treatment Outcome; D014654:Vascular Patency
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene