Peripheral arterial aneurysms: A prospective study of 30 cases

Peripheral arterial aneurysms (PrAAs), characterized by localized dilatation, arise from the complex interplay between biological processes within the arterial wall and the hemodynamic forces affecting the arterial wall. The main objective of the present study was to identify and analyze short-term and long-term outcomes of surgical repair in this patient population. A retrospective analysis was performed on 30 patients operated for PrAAs over 10 years. Data were reviewed, and the outcomes of open revascularization were analyzed. Clinical categories, operative indications and statistical analyses were defined. A total of 32 PrAAs were treated in 30 patients, consisting of 22 (73.3%) men and 8 (26.7%) women. There were 28 (93.3%) unilateral and 2 (6.7%) bilateral PrAAs with a mean aneurysmal diameter of 3.4167±1.00438 cm. A total of 6 aneurysms (18.75%) were asymptomatic at presentation (Group 1), 20 aneurysms (62.5%) had chronic limb-threatening ischemia (Group 2) and 6 aneurysms (18.75%) presented with acute limb ischemia (Group 3). All 32 PrAAs were repaired by interposition graft (endoaneurysmorrhaphy) and the conduit was an autogenous great saphenous vein graft in the majority of the patients with the minority repaired using prosthetics [Group 1, n=21 (70.0%); Group 2, n=3 (10.0%) and Group 3, n=6 (20.0%)]. In the first 30 days, systemic complications occurred in 3 patients only. No amputation was needed in the first 30 days and no mortality was recorded. The overall 2-year primary patency was 26/32 (81.25%). For the great saphenous vein, the primary patency was 19/21 (90.47%), and the secondary patency was 20/21 (95.23%). The 2-year freedom from re-intervention owing to PrAA recurrence was 100%. Overall limb loss was 6.25 % (2/32). In conclusion, the present study confirmed the effectiveness of open surgical repair, especially endoaneurysmorrhaphy, in achieving significant outcomes, including primary and secondary patency rates, and minimal rates of limb loss and mortality.