Endovascular treatment of popliteal artery aneurysms: results of a prospective cohort study.
OBJECTIVE
Popliteal artery aneurysms can be treated endovascularly with less perioperative morbidity compared with open repair. To evaluate suitability of the endovascular technique and the clinical results of this treatment, we analyzed a prospective cohort of consecutive popliteal aneurysms referred to a tertiary university vascular center.


METHODS
All popliteal artery aneurysms between June 1998 and June 2004 that measured >20 mm in diameter were analyzed for endovascular repair. Anatomic suitability was based largely on quality of the proximal and distal landing zone as determined by angiography. Endovascular treatment was performed by using a nitinol-supported expanded polytetrafluoroethylene lined stent graft introduced through the common femoral artery.


RESULTS
We analyzed 67 aneurysms in 57 patients. Ten aneurysms (15%) were excluded from endovascular repair, or from any repair at all, for various reasons. The remaining 57 (85%) were treated endovascularly, of which 5 were treated emergently for acute ischemia. During a mean 24-month follow-up, 12 stent grafts (21%) occluded. Primary and secondary patency rates were 80% and 90% at 1 year, and 77% and 87% at 2 years of follow-up. Postoperative treatment with clopidogrel proved to be the only significant predictor for success.


CONCLUSIONS
Endovascular repair of a popliteal artery aneurysm is feasible. Changes in the material used and the addition of clopidogrel may improve patency rates.
Tielliu
Ignace F J
IF
Department of Surgery, University Medical Center Groningen, The Netherlands. i.tielliu@chir.umcg.nl <i.tielliu@chir.umcg.nl>
Verhoeven
Eric L G
EL
Zeebregts
Clark J
CJ
Prins
Ted R
TR
Span
Mark M
MM
van den Dungen
Jan J A M
JJ
D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000601:surgery*; D017130:Angioplasty; D019917:Blood Vessel Prosthesis Implantation; D000077144:Clopidogrel; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011150:Popliteal Artery / Q000601:surgery*; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine