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Elective popliteal aneurysms: does venous availability has an impact on indications?
A Bourriez1, D Melliere, P Desgranges
1Department of Vascular Surgery, Henri Mondor Hospital, AP-HP, Paris Val de Marne University, Creteil, France.
The Journal of Cardiovascular Surgery
|March 29, 2005
Summary
Vein grafts show superior long-term patency for popliteal aneurysms compared to prosthetic grafts. For small, uncomplicated aneurysms, assess vein availability before choosing prosthetic intervention due to higher occlusion risk.
Area of Science:
- Vascular Surgery
- Biomaterials Science
Background:
- Popliteal aneurysms require careful management to prevent limb-threatening complications.
- Treatment decisions for small, asymptomatic popliteal aneurysms are debated, especially when autologous vein conduits are unavailable.
Purpose of the Study:
- To compare the patency and limb salvage rates of venous bypasses versus prosthetic bypasses for popliteal aneurysms.
- To inform treatment strategies for small, uncomplicated popliteal aneurysms when a venous conduit is not readily available.
Main Methods:
- Retrospective analysis of 100 popliteal aneurysm repairs over 18 years.
- Comparison of outcomes between 80 venous bypasses (Group I) and 20 prosthetic bypasses (Group II).
Main Results:
- Prosthetic bypasses (Group II) had significantly lower primary patency (61.5%), assisted primary patency (89%), and secondary patency (88.4%) at 2 years compared to venous bypasses (Group I: 94.3%, 97.3%, 98.7%).
- Late arterial complications were more frequent with prosthetic grafts.
- Limb salvage rates were comparable between venous and prosthetic grafts (98.7% vs 100%).
Conclusions:
- Vein grafts are associated with a lower risk of late occlusion compared to prosthetic grafts for popliteal aneurysms.
- The availability of a suitable vein conduit should be a primary consideration when deciding on the surgical approach for small, uncomplicated popliteal aneurysms.