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.
Presentation Type
Event
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.