[New Aspects of Endovascular Treatment for Popliteal Aneurysms: First Results of a Pilot Trial]

Popliteal aneurysms are the most often diagnosed peripheral aneurysms and are often associated with chronic occlusive disease or acute thrombosis with limb-threatening critical ischaemia. Rupture is a rare event. Due to the immense risk of limb loss, early treatment in the asymptomatic stage is recommended either with surgical bypass, interposition or endovascular means using covered stents. Published data are inconclusive concerning endovascular treatment and implant costs are high. An alternative strategy consists in using flow diverters with optimal material characteristics for use in the popliteal artery, in our study this is represented by a woven nitinol bare metal stent with extreme flexibility and high radial force resistance. In this pilot study 13 aneurysms were treated successfully with promising results after 2 to 23 months follow-up. Technical success was achieved in 100 % with complete aneurysm thrombosis and no perioperative complications such as stent fractures, device migration or separation could be detected. Implant costs were significantly lower compared to those for covered stents. The re-occlusion rate was lower for electively treated patients compared to aneurysms treated in an acute stadium of thrombosis treated with rotational aspiration and thrombolysis. The given results allow us to query the need for complete aneurysm exclusion with covered stents or bypasses.