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Endovascular exclusion of popliteal artery aneurysms with stent-grafts: a prospective single-center experience
Gary M Idelchik1, Kathryn G Dougherty, Eduardo Hernandez
1Division of Cardiology, the Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
Purpose:
To determine the safety and efficacy of percutaneous treatment for popliteal artery aneurysms (PAA) using self-expanding stent-grafts.
Methods:
From October 2000 through September 2007, 29 patients (27 men; mean age 68+/-6 years, range 54-88) underwent endovascular exclusion of 33 PAAs. All had symptoms of claudication, and all were atherosclerotic in origin. Four patients presented with popliteal venous thrombosis. Twenty-eight of the treated PAAs had associated mural thrombus. The mean aneurysm diameter was 34.3+/-13.3 mm and the mean lesion length was 98.6+/-102.1 mm.
Results:
All PAAs were successfully excluded from the arterial circulation using 59 stent-grafts (15 Wallgraft and 44 Viabahn). The average number of stent-grafts implanted was 1.9+/-0.4 (range 1-3); the mean length of covered vessel (per lesion) was 198.6+/-105.3 mm. There were no device-associated complications or deaths. Over an average follow-up of 35.4+/-32.1 months (range 6-120), the primary and secondary patency rates, respectively, were 93.9% and 100% at 6 months, 93.9% and 96.9% at 1 year, and 87.5% and 96.8% at 2 years. At 4.5 years, primary and secondary patency rates were 84.8% and 96.8%, respectively. No endoleaks, aneurysm rupture, thromboembolism, or limb loss occurred at follow-up.
Conclusion:
Stent-graft exclusion of PAAs is safe and effective, yielding primary and secondary patency rates comparable to surgical repair. In spite of encouraging results in this study, further larger studies are warranted to reconfirm our observations.
