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Increasing the Elective Endovascular to Open Repair Ratio of Popliteal Artery Aneurysm

Wrede, Axel; Wiberg, Frans LU and Acosta, Stefan LU (2018) In Vascular and Endovascular Surgery 52(2). p.115-123
Abstract

Background: Open repair (OR) for popliteal artery aneurysm (PAA) has recently been challenged by endovascular repair (ER) as the primary choice of treatment. The aim of the present study was to evaluate time trends in treatment modality and compare outcomes between OR and ER among electively operated patients after start of screening in 2010 for abdominal aortic aneurysm (AAA), a disease highly associated with PAA. Methods: Between January 1, 2009, and April 30, 2017, 102 procedures and 36 acute and 66 elective repairs for PAA were identified. Results: Over time, a trend (P =.089) for an increasing elective to acute repair ratio of PAA and an increase in elective ER to OR ratio (P =.003) was found. Among electively repaired PAAs, the ER... (More)

Background: Open repair (OR) for popliteal artery aneurysm (PAA) has recently been challenged by endovascular repair (ER) as the primary choice of treatment. The aim of the present study was to evaluate time trends in treatment modality and compare outcomes between OR and ER among electively operated patients after start of screening in 2010 for abdominal aortic aneurysm (AAA), a disease highly associated with PAA. Methods: Between January 1, 2009, and April 30, 2017, 102 procedures and 36 acute and 66 elective repairs for PAA were identified. Results: Over time, a trend (P =.089) for an increasing elective to acute repair ratio of PAA and an increase in elective ER to OR ratio (P =.003) was found. Among electively repaired PAAs, the ER group was older (P =.047) and had a higher ankle–brachial index (ABI; P =.044). The ER group had fewer wound infections (P =.003), fewer major bleeding complications (P =.046), and shorter in-hospital stay (P <.001). After 1 year of follow-up, the ER group had a higher rate of major amputations (P =.037). Amputation-free survival at the end of follow-up did not differ between groups (P =.68). Among the 17 patients with PAA eligible for AAA screening, 4 (24%) were diagnosed with PAA through the screening program of AAA. Conclusion: The epidemiology of elective repair of PAA has changed toward increased ER, although ER showed a higher rate of major amputations at 1 year. Confounding was considerable and a randomized trial is needed for evaluation of the best therapeutic option.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
abdominal aortic aneurysm, elective repair, endovascular repair, popliteal artery aneurysm, screening
in
Vascular and Endovascular Surgery
volume
52
issue
2
pages
115 - 123
publisher
SAGE Publications Inc.
external identifiers
  • scopus:85040449711
ISSN
1538-5744
DOI
language
English
LU publication?
yes
id
e076fdc2-a09f-4dc9-b3fa-64eea55f943c
date added to LUP
2018-02-05 15:10:03
date last changed
2018-05-29 11:06:18
@article{e076fdc2-a09f-4dc9-b3fa-64eea55f943c,
  abstract     = {<p>Background: Open repair (OR) for popliteal artery aneurysm (PAA) has recently been challenged by endovascular repair (ER) as the primary choice of treatment. The aim of the present study was to evaluate time trends in treatment modality and compare outcomes between OR and ER among electively operated patients after start of screening in 2010 for abdominal aortic aneurysm (AAA), a disease highly associated with PAA. Methods: Between January 1, 2009, and April 30, 2017, 102 procedures and 36 acute and 66 elective repairs for PAA were identified. Results: Over time, a trend (P =.089) for an increasing elective to acute repair ratio of PAA and an increase in elective ER to OR ratio (P =.003) was found. Among electively repaired PAAs, the ER group was older (P =.047) and had a higher ankle–brachial index (ABI; P =.044). The ER group had fewer wound infections (P =.003), fewer major bleeding complications (P =.046), and shorter in-hospital stay (P &lt;.001). After 1 year of follow-up, the ER group had a higher rate of major amputations (P =.037). Amputation-free survival at the end of follow-up did not differ between groups (P =.68). Among the 17 patients with PAA eligible for AAA screening, 4 (24%) were diagnosed with PAA through the screening program of AAA. Conclusion: The epidemiology of elective repair of PAA has changed toward increased ER, although ER showed a higher rate of major amputations at 1 year. Confounding was considerable and a randomized trial is needed for evaluation of the best therapeutic option.</p>},
  author       = {Wrede, Axel and Wiberg, Frans and Acosta, Stefan},
  issn         = {1538-5744},
  keyword      = {abdominal aortic aneurysm,elective repair,endovascular repair,popliteal artery aneurysm,screening},
  language     = {eng},
  month        = {02},
  number       = {2},
  pages        = {115--123},
  publisher    = {SAGE Publications Inc.},
  series       = {Vascular and Endovascular Surgery},
  title        = {Increasing the Elective Endovascular to Open Repair Ratio of Popliteal Artery Aneurysm},
  url          = {http://dx.doi.org/},
  volume       = {52},
  year         = {2018},
}