title: Endovascular versus open repair of popliteal artery aneurysms: outcomes in the US Medicare population.
abstract: OBJECTIVE
  The management of popliteal artery aneurysms (PAAs) has undergone significant transition from open surgery to endovascular graft placement with few longitudinal data evaluating outcomes.
  
  
  METHODS
  The Centers of Medicare & Medicaid Services Inpatient claims (2005-2007) were queried with a diagnosis of lower extremity artery aneurysm in association with elective Current Procedural Terminology codes for open (OPEN group) and endovascular (ENDO group) repair.
  
  
  RESULTS
  A total of 2962 patients were identified. Endovascular interventions significantly increased over the time of the study (11.7% vs 23.6%, P < .0001). Overall complication rates for OPEN and ENDO groups did not differ significantly (11.3% vs 9.3%; P = .017). No differences in the 30- and 90-day mortality rates were found between OPEN versus ENDO groups. The ENDO group had greater 30- and 90-day reinterventions (4.6% vs 2.1%, P = .001 and 11.8% vs 7.4%, P = .0007, respectively). Length of stay (4.5 days vs 2.5 days, P < .0001) and charges ($43 180 vs $35 540, P < .0001) were greater for OPEN group.
  
  
  CONCLUSIONS
  Despite a significant increase in the utilization of endovascular repair of PAAs, endovascular repair was associated with greater reinterventions over time and did not offer a mortality or cost benefit.
authors: Division of Vascular Surgery, University of Missouri, School of Medicine, Columbia, MO, USA.
authors: Edgar Luis
authors: EL
authors: Galiñanes
authors: Viktor Y
authors: VY
authors: Dombrovskiy
authors: Alan M
authors: AM
authors: Graham
authors: Todd R
authors: TR
authors: Vogel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000191:economics / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000191:economics / Q000401:mortality; D014487:Centers for Medicare and Medicaid Services, U.S.; D016009:Chi-Square Distribution; D003362:Cost-Benefit Analysis; D057510:Endovascular Procedures / Q000009:adverse effects / Q000191:economics / Q000401:mortality; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D006278:Medicare / Q000191:economics; D015999:Multivariate Analysis; D016017:Odds Ratio; D011150:Popliteal Artery / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
keywords: endovascular; open; outcomes; popliteal artery aneurysm