Endovascular treatment of femoropopliteal aneurysms: a five-year experience.
OBJECTIVE
To assess the effectiveness of endovascular treatment of femoropopliteal aneurysms (FPAs).


METHODS
In the last 5 years, we have treated 17 FPAs (diameter 21-75 cm, mean 38.4 cm; length 27-100 cm, mean 72.5 cm) in 15 patients (age 57-80 years, mean 70.9 years). The diagnosis was obtained by color Doppler ultrasound (CDU) and the procedure was planned by CT angiography (CTA) and preprocedural angiography. Eight FPAs were excluded with only one stent-graft; in 8 patients, two stent-grafts were positioned; and in 1 patient, three stent-grafts were used. In 14 cases we used a Wallgraft endoprosthesis, in 2 cases a Hemobahn, and in 1 case an Excluder contralateral leg. The patients were followed up with CDU and occasionally with CTA.


RESULTS
Immediate technical success was obtained in 17 of 17 cases (100%). One patient died during the first year. During a mean follow-up of 26.9 months (range 3-60 months) we observed 6 of 16 (38%) stent-graft occlusions (3 of which were recanalized with locoregional thrombolysis and 3 with mechanical thrombectomy). Two stent-grafts were patent at 12 and 24 months. Four patients experienced subsequent occlusions and recanalizations until corrected by surgical bypass (1 at 14 months, 2 at 18 months, and 1 at 36 months). Therefore the primary patency was 63% and assisted patency was 73%.


CONCLUSIONS
The endovascular approach is a minimally invasive treatment option for FPAs. Moreover endovascular stent-grafting does not necessarily preclude conventional surgical repair, but it can delay it. Longer follow-up will be needed to determine the long-term patency rate.
Laganà
Domenico
D
Department of Radiology, University of Insubria, Viale Borri, 57-21100 Varese, Italy. donlaga@gmail.com
Carrafiello
Gianpaolo
G
Mangini
Monica
M
Caronno
Roberto
R
Giorgianni
Andrea
A
Lumia
Domenico
D
Castelli
Patrizio
P
Fugazzola
Carlo
C
D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation; D002406:Catheterization, Peripheral; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006083:Graft Occlusion, Vascular / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging; D015641:Radiography, Interventional; D015607:Stents; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color