Contemporary Treatment of Popliteal Artery Aneurysms in 14 Countries : A Vascunet Report

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Grip , O , Mani , K , Altreuther , M , Goncalves , F B , Beiles , B , Cassar , K , Davidovic , L , Eldrup , N , Lattmann , T , Laxdal , E , Menyhei , G , Setacci , C , Settembre , N , Thomson , I , Venermo , M & Björck , M 2020 , ' Contemporary Treatment of Popliteal Artery Aneurysms in 14 Countries : A Vascunet Report ' , European Journal of Vascular and Endovascular Surgery , vol. 60 , no. 5 , pp. 721-729 . https://doi.org/10.1016/j.ejvs.2020.07.005

Title: Contemporary Treatment of Popliteal Artery Aneurysms in 14 Countries : A Vascunet Report
Author: Grip, Olivia; Mani, Kevin; Altreuther, Martin; Goncalves, Frederico Bastos; Beiles, Barry; Cassar, Kevin; Davidovic, Lazar; Eldrup, Nikolaj; Lattmann, Thomas; Laxdal, Elin; Menyhei, Gabor; Setacci, Carlo; Settembre, Nicla; Thomson, Ian; Venermo, Maarit; Björck, Martin
Contributor: University of Helsinki, Verisuonikirurgian yksikkö
Date: 2020-11
Language: eng
Number of pages: 9
Belongs to series: European Journal of Vascular and Endovascular Surgery
ISSN: 1078-5884
URI: http://hdl.handle.net/10138/322307
Abstract: Objective: Popliteal artery aneurysm (PAA) is the second most common arterial aneurysm. Vascunet is an international collaboration of vascular registries. The aim was to study treatment and outcomes. Methods: This was a retrospective analysis of prospectively registered population based data. Fourteen countries contributed data (Australia, Denmark, Finland, France, Hungary, Iceland, Italy, Malta, New Zealand, Norway, Portugal, Serbia, Sweden, and Switzerland). Results: During 2012-2018, data from 10 764 PAA repairs were included. Mean values with between countries ranges in parenthesis are given. The incidence was 10.4 cases/million inhabitants/year (2.4-19.3). The mean age was 71.3 years (66.8-75.3). Most patients, 93.3%, were men and 40.0% were active smokers. The operations were elective in 73.2% (60.0%-85.7%). The mean pre-operative PAA diameter was 32.1 mm (27.3-38.3 mm). Open surgery dominated in both elective (79.5%) and acute (83.2%) cases. A medial surgical approach was used in 77.7%, and posterior in 22.3%. Vein grafts were used in 63.8%. Of the emergency procedures, 91% (n = 2 169, 20.2% of all) were for acute thrombosis and 9% for rupture (n = 236, 2.2% of all). Thrombosis patients had larger aneurysms, mean diameter 35.5 mm, and 46.3% were active smokers. Early amputation and death were higher after acute presentation than after elective surgery (5.0% vs. 0.7%; 1.9% vs. 0.5%). This pattern remained one year after surgery (8.5% vs. 1.0%; 6.1% vs. 1.4%). Elective open compared with endovascular surgery had similar one year amputation rates (1.2% vs. 0.2%; p = .095) but superior patency (84.0% vs. 78.4%; p = .005). Veins had higher patency and lower amputation rates, at one year compared with synthetic grafts (86.8% vs. 72.3%; 1.8% vs. 5.2%; both p <.001). The posterior open approach had a lower amputation rate (0.0% vs. 1.6%, p = .009) than the medial approach. Conclusion: Patients presenting with acute ischaemia had high risk of amputation. The frequent use of endovascular repair and prosthetic grafts should be reconsidered based on these results.
Subject: Aneurysm - popliteal artery
Endovascular
Epidemiology
Open surgery
Registry
EDITORS CHOICE
SURGICAL-MANAGEMENT
EUROPEAN-SOCIETY
OPEN REPAIR
SURGERY
VALIDATION
OUTCOMES
BYPASS
GUIDELINES
NATIONWIDE
3126 Surgery, anesthesiology, intensive care, radiology
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