Dorsal (posterior) versus medial approach for the surgical repair of popliteal artery aneurysms.
The surgical approach-of-choice for the management of popliteal artery aneurysms (PAAs) remains controversial. We compared the results of the medial (MA) and dorsal (posterior) surgical approach (DA). Fifty patients (44 males/6 females; median age [range]: 59 [49-84] years) treated for 58 atherosclerotic PAAs were studied (MA: 29 PAAs; DA: 29 PAAs). The 3-year graft patency rates were higher after DA compared with MA (76% vs 52%, respectively), but the difference was not significant (P = .056). There were no differences between the 2 approaches in amputation, restenosis, reoperation, and wound infection rates. Dorsal approach and the MA may be alternative approaches with similar long-term results. Due to the controversial results reported so far, a meta-analysis may be necessary to establish the surgical approach-of-choice. Future studies should take into account additional factors, other than the surgical technique, when assessing outcome (eg, preoperative statin use, age, and emergency vs routine surgery).
Bisdas
Theodosios
T
Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Germany.
Paraskevas
Kosmas I
KI
Pichlmaier
Maximilian
M
Wilhelmi
Matthias
M
Haverich
Axel
A
Teebken
Omke Enno
OE
D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000601:surgery*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D012086:Reoperation; D016896:Treatment Outcome; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000379:methods*