Endovascular treatment of lower extremity aneurysms.
Endovascular popliteal aneurysm repair (EVPAR) has made modest progress toward recognition as a viable alternative to open surgical repair. Recent reports show that EVPAR can be accomplished with minimal perioperative morbidity and mortality. Patency rates are less than those noted for saphenous vein reconstruction, yet limb loss following EVPAR appears to be a relatively rare occurrence. This article will address the selection of potential candidates for EVPAR, as well as useful imaging modalities, preoperative planning and device selection, and techniques to optimize endograft deployment. Suggestions for adjunctive pharmacotherapy and graft monitoring are presented. While EVPAR is unlikely to displace open surgical repair in the near future, it provides a valuable alternative for selected patients.
Geraghty
Patrick J
PJ
Department of Surgery, Washington University Medical School, St. Louis, MO 63110, USA. geraghtyp@wustl.edu
D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D019060:Minimally Invasive Surgical Procedures; D018579:Patient Selection; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011182:Postoperative Care; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation; D018570:Risk Assessment; D015607:Stents; D016896:Treatment Outcome