Elective popliteal aneurysms: does venous availability has an impact on indications?
OBJECTIVE
The aim of this retrospective study was to evaluate the patency and limb salvage rates after prosthetics or venous bypasses for asymptomatic or mildly symptomatic popliteal aneurysms, in order to determine if small uncomplicated aneurysms (caliber <300%) should be operated or periodically controlled when a venous conduit is not available.


METHODS
During a 18 years period, 100 popliteal aneurysms, including 85 asymptomatic and 15 associated with intermittent claudication, were operated on: group I consisted of 80 venous bypasses, and group II consisted of 20 prosthetic bypasses.


RESULTS
Demographics and risks factors were similar in both groups. Local complications were more frequent in group I (17% vs 10% p=NS). Early vascular complications were rare in both groups. Late arterial complications were more frequent in group II. Primary patency, assisted primary patency, and secondary patency rates at 2 years were 94.3%, 97.3% and 98.7% in group I, and 61.5%, 89% and 88.4% in group II (p<0.05). In contrast, the limbs salvage rates were not significantly different for each type of graft (98.7% vs 100% p=NS).


CONCLUSIONS
Our data shows that aneurysms treated with a prosthetic graft are at higher risk of late occlusion than those operated with a vein graft. This should be taken into account when facing a small uncomplicated aneurysm without available venous conduit. The presence of a suitable vein should be checked before deciding to operate a small uncomplicated popliteal aneurysm.
Bourriez
A
A
Department of Vascular Surgery, Henri Mondor Hospital, AP-HP, Paris Val de Marne University, Creteil, France.
Melliere
D
D
Desgranges
P
P
D'Audiffret
A
A
Allaire
E
E
Becquemin
J P
JP
D000368:Aged; D000783:Aneurysm / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000592:standards; D017558:Elective Surgical Procedures / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology; D023821:Limb Salvage; D008297:Male; D011138:Polytetrafluoroethylene / Q000627:therapeutic use; D011150:Popliteal Artery / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000503:physiopathology / Q000637:transplantation; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
D011138:Polytetrafluoroethylene