Endovascular Popliteal Artery Aneurysm Repair Using an "Off-Label" Abdominal Endograft Limb-Module with Nitinol-Ring...

Area of Science:

• Vascular Surgery
• Endovascular Interventions
• Aneurysm Repair

Background:

• Popliteal artery aneurysms (PAAs) are a common manifestation of peripheral arterial disease.
• Endovascular repair is an alternative to open surgery, especially for high-risk patients.
• The Anaconda™ endograft limb, an abdominal endograft module, has been used off-label for PAA repair.

Purpose of the Study:

• To evaluate the outcomes of endovascular popliteal artery aneurysm repair using the Anaconda™ endograft limb.
• To assess technical success, primary patency, re-intervention rates, and survival.
• To determine the feasibility of this off-label use in a single teaching hospital.

Main Methods:

• Retrospective observational study of 14 PAAs in 12 male patients (mean age 76).
• Treatment involved elective repair using the Anaconda™ endograft limb.
• Follow-up duration was a median of 3.7 years, assessing aneurysm exclusion, patency, re-intervention, and survival.

Main Results:

• Successful stent-graft deployment and aneurysm exclusion in all patients.
• Primary patency rates were 93% at 1 year, 75% at 3 years, and 64% at 4 years.
• By 8 years, patency declined to 29%; 7/14 limbs occluded, with 3 re-interventions. Freedom from re-intervention and survival at 5 years was 84% and 67%, respectively.

Conclusions:

• The Anaconda™ endograft limb provides good mid-term and acceptable long-term patency for PAA repair up to 4 years.
• This off-label approach can be considered for older, comorbid patients unsuitable for open surgery.
• Percutaneous repair is feasible under local anesthesia when anatomically suitable.