title: Outcome of endovascular repair of popliteal artery aneurysm using the Viabahn endoprosthesis.
abstract: OBJECTIVE
  This study reviews a single-center experience of endovascular popliteal aneurysm (PAA) repair.
  
  
  METHODS
  A retrospective review was performed to identify all endovascular PAA repairs performed between September 2004 and January 2011.
  
  
  RESULTS
  We identified 21 patients (mean age, 74 ± 9 years, 91% men) with PAAs (mean size, 2.89 ± 1.0 cm) in 26 limbs, of which 38% were symptomatic. All patients underwent endovascular repair with a Viabahn covered stent graft (W. L. Gore & Assoc, Inc, Flagstaff, Ariz). Postoperatively, all patients were maintained on antiplatelet therapy with clopidogrel or aspirin, or both. Mean follow-up was 22 ± 17 months (range, 1-57 months). One patient with one aneurysm was lost to follow-up. Primary and secondary patencies were both 91.2% at 1 year and were 85.5% and 91.2%, respectively, at 2 years. The limb salvage rate was 100%. Four stent graft failures occurred at a mean of 12.3 ± 11 months. One technical failure due to stent graft infolding required conversion to an open femoral-popliteal bypass. Three additional graft failures occurred in patients with poor (single-vessel) runoff. Compared with patients with two- or three-vessel runoff, the graft failure rate in patients with single-vessel runoff was statistically significant (P = .02). Two of the graft failures were successfully treated with open thrombectomy, and one required a tibial artery bypass for limb salvage.
  
  
  CONCLUSIONS
  Endovascular repair of PAAs is feasible and has acceptable midterm patency rates. Poor distal runoff predicted graft failure.
authors.affiliation: Division of Vascular and Endovascular Surgery, New York University School of Medicine, New York, NY 10016, USA.
authors.forename: Karan
authors.initials: K
authors.lastname: Garg
authors.forename: Caron B
authors.initials: CB
authors.lastname: Rockman
authors.forename: Billy J
authors.initials: BJ
authors.lastname: Kim
authors.forename: Glenn R
authors.initials: GR
authors.lastname: Jacobowitz
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Maldonado
authors.forename: Mark A
authors.initials: MA
authors.lastname: Adelman
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Veith
authors.forename: Neal S
authors.initials: NS
authors.lastname: Cayne
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D009519:New York City; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D010975:Platelet Aggregation Inhibitors