Popliteal Artery Aneurysm Surgery: The Role of Emergency Setting

• Published in: Vascular and endovascular surgery 2008-04, Vol.42 (2), p.159-164
• Main Authors: Lichtenfels, Eduardo, Frankini, Airton Delduque, Bonamigo, Telmo Pedro, Cardozo, Marco Aurelio, Schulte, Alfredo Augusto
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Aneurysm - complications; Aneurysm - diagnostic imaging; Aneurysm - physiopathology; Aneurysm - surgery; Biological and medical sciences; Blood Vessel Prosthesis Implantation - adverse effects; Elective Surgical Procedures; Emergency Treatment; Female; Humans; Limb Salvage; Male; Medical sciences; Middle Aged; Popliteal Artery - diagnostic imaging; Popliteal Artery - physiopathology; Popliteal Artery - surgery; Prospective Studies; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Treatment Outcome; Ultrasonography; Vascular Patency; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
• ISSN: 1538-5744; 1938-9116
• DOI: 10.1177/1538574407308201

The aim of this study was to compare the outcomes of emergent surgery caused by acute complications versus elective surgery of popliteal artery aneurysms (PAAs) and to evaluate the advantages of elective repair related to limb salvage and bypass patency rates. Fifty PAAs were operated on in 40 patients from January 2000 to December 2004. Surgery was elective in 34 cases (68%) and emergent in 16 (32%). Emergent repair was performed because of acute complications. All patients were treated surgically. Early results in terms of limb salvage, primary patency, and assisted patency were assessed. Follow-up consisted of clinical and/or ultrasonographic examinations at 10 days and 1, 3, 6, and 12 months and yearly thereafter. Long-term limb salvage and bypass patency rates were analyzed. The mean follow-up was 17 months. The 1-year limb salvage rate in the elective group was 97.1% versus 56.3% in the emergent group (P = .0007). The bypass patency rate at 1 year was 94.1% in the elective group versus 66.7% in the emergent group (P = .03). In this study, the outcomes of the PAA repair were significantly better in the group operated electively and without acute symptoms at presentation compared with the group with acute complications, operated on emergently, especially related to limb salvage and bypass patency rates.