Abstract/Description
Objective: To compare long-term outcomes of popliteal artery aneurysm (PAA) repair via open surgical bypass and endovascular stenting, focusing on patency, freedom from major amputation, and reintervention rate.
Methods: A retrospective review of all limbs treated for PAA from 2008–2024 across a single healthcare system was conducted. Baseline demographics, clinical presentation, operative details, and postoperative outcomes were collected. Long-term outcomes (≥ 5 years) included primary, primary assisted, and secondary patency, reintervention rate, major adverse cardiac events (MACE), major adverse limb events (MALE), freedom from major amputation, and all-cause mortality. Statistical analyses were done as appropriate utilizing SPSS.
Results: We identified 222 limbs in 183 patients who underwent PAA repair (171 open surgical, and 51 endovascular stent). Endovascular repair patients had shorter hospital length of stay (1 [IQR 0-1] vs. 3 [IQR 2-5] days, p < 0.001) but experienced significantly higher rates of reintervention compared to open repair (86.3% vs. 50.9%, p < 0.001). Primary patency in the open and endovascular repair groups at 1, 3, and 5 years was (79.8% vs. 72.1%, 70.8% vs. 58.5%, and 67.3% vs. 58.5%, p = 0.036) respectively (Figure 1), but there were no significant differences in freedom from major amputation between groups (Figure 2).
Conclusions: Endovascular repair offers shorter hospital length of stay and comparable long-term freedom from major amputation to open repair, but at the cost of higher reintervention rates. Technique selection should consider age, comorbidities, and symptomatology to optimize surgical outcomes.
Faculty Advisor/Mentor
Jean M. Panneton
Faculty Advisor/Mentor Department
Vascular Surgery
College/School/Affiliation
Eastern Virginia Medical School (EVMS)
Included in
A 16-year Experience of Popliteal Artery Aneurysm Repair: Endovascular Stent Grafting Matches Surgical Bypass at a Cost of Much Higher Reintervention Rates
Objective: To compare long-term outcomes of popliteal artery aneurysm (PAA) repair via open surgical bypass and endovascular stenting, focusing on patency, freedom from major amputation, and reintervention rate.
Methods: A retrospective review of all limbs treated for PAA from 2008–2024 across a single healthcare system was conducted. Baseline demographics, clinical presentation, operative details, and postoperative outcomes were collected. Long-term outcomes (≥ 5 years) included primary, primary assisted, and secondary patency, reintervention rate, major adverse cardiac events (MACE), major adverse limb events (MALE), freedom from major amputation, and all-cause mortality. Statistical analyses were done as appropriate utilizing SPSS.
Results: We identified 222 limbs in 183 patients who underwent PAA repair (171 open surgical, and 51 endovascular stent). Endovascular repair patients had shorter hospital length of stay (1 [IQR 0-1] vs. 3 [IQR 2-5] days, p < 0.001) but experienced significantly higher rates of reintervention compared to open repair (86.3% vs. 50.9%, p < 0.001). Primary patency in the open and endovascular repair groups at 1, 3, and 5 years was (79.8% vs. 72.1%, 70.8% vs. 58.5%, and 67.3% vs. 58.5%, p = 0.036) respectively (Figure 1), but there were no significant differences in freedom from major amputation between groups (Figure 2).
Conclusions: Endovascular repair offers shorter hospital length of stay and comparable long-term freedom from major amputation to open repair, but at the cost of higher reintervention rates. Technique selection should consider age, comorbidities, and symptomatology to optimize surgical outcomes.