title: Editor's Choice: Contemporary treatment of popliteal artery aneurysm in eight countries: A Report from the Vascunet collaboration of registries.
abstract: OBJECTIVE
  To study contemporary popliteal artery aneurysm (PA) repair.
  
  
  METHODS
  Vascunet is a collaboration of population-based registries in 10 countries: eight had data on PA repair (Australia, Finland, Hungary, Iceland, New Zealand, Norway, Sweden, and Switzerland).
  
  
  RESULTS
  From January 2009 until June 2012, 1,471 PA repairs were registered. There were 9.59 operations per million person years, varying from 3.4 in Hungary to 17.6 in Sweden. Median age was 70 years, ranging from 66 years in Switzerland and Iceland to 74 years in Australia and New Zealand; 95.6% were men and 44% were active smokers. Elective surgery dominated, comprising 72% of all cases, but only 26.2% in Hungary and 39.7% in Finland, (p < .0001). The proportion of endovascular PA repair was 22.2%, varying from 34.7% in Australia, to zero in Switzerland, Finland, and Iceland (p < .0001). Endovascular repair was performed in 12.2% of patients with acute thrombosis and 24.1% of elective cases (p < .0001). A vein graft was used in 87.2% of open repairs, a synthetic or composite graft in 12.7%. Follow-up was until discharge or 30 days. Amputation rate was 2.0% overall: 6.5% after acute thrombosis, 1.0% after endovascular, 1.8% after open repair, and 26.3% after hybrid repair (p < .0001). Mortality was 0.7% overall: 0.1% after elective repair, 1.6% after acute thrombosis, and 11.1% after rupture.
  
  
  CONCLUSIONS
  Great variability between countries in incidence of operations, indications for surgery, and choice of surgical technique was found, possibly a result of surgical tradition rather than differences in case mix. Comparative studies with longer follow-up data are warranted.
authors.affiliation: Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden. Electronic address: martin@bjorck.pp.se.
authors.forename: M
authors.initials: M
authors.lastname: Björck
authors.affiliation: Western Hospital, Melbourne, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Beiles
authors.affiliation: Department of Vascular Surgery Medical Centre, Pecs University, Pecs, Hungary.
authors.forename: G
authors.initials: G
authors.lastname: Menyhei
authors.affiliation: Department of Surgical Sciences, Otago University, Dunedin, New Zealand.
authors.forename: I
authors.initials: I
authors.lastname: Thomson
authors.affiliation: Cantonal Hospital, Winterthur, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Wigger
authors.affiliation: Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Venermo
authors.affiliation: Department of Vascular Surgery, Haukeland University Hospital, Bergen, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Laxdal
authors.affiliation: Department of Vascular Surgery, Reykjavik University Hospital, Reykjavik, Iceland.
authors.forename: G
authors.initials: G
authors.lastname: Danielsson
authors.affiliation: Northern Vascular Centre, Newcastle Upon Tyne Hospitals NHS Trust, UK.
authors.forename: T
authors.initials: T
authors.lastname: Lees
authors.affiliation: Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden; Department of Surgery, Blekinge Hospital, Karlskrona, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Troëng
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D000783:Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001315:Australia; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality / Q000639:trends; D016009:Chi-Square Distribution; D003299:Cooperative Behavior; D017558:Elective Surgical Procedures; D004630:Emergencies; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality / Q000639:trends; D005060:Europe; D005260:Female; D006801:Humans; D007391:International Cooperation; D023821:Limb Salvage; D008297:Male; D009520:New Zealand; D011150:Popliteal Artery / Q000601:surgery*; D010818:Practice Patterns, Physicians' / Q000639:trends; D012042:Registries; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Aneurysm; Endovascular; Epidemiology; Popliteal artery; Population-based; Registry; Vascular surgery