Department of Vascular Surgery, University Hospital Bordeaux, Bordeaux, France.
J Vasc Surg. 2010 Apr;51(4):850-6. doi: 10.1016/j.jvs.2009.10.107. Epub 2010 Feb 7.
To evaluate the feasibility of endovascular exclusion of popliteal artery aneurysm (PAA) using stent grafts.
The clinical data of all patients who underwent endovascular exclusion of PAA at three French vascular departments between December 1999 and December 2007 were retrospectively analyzed. Outcome measures included graft patency and endoleak. The Kaplan-Meier method was used to calculate the primary and secondary patency curves.
A total of 57 PAA in 50 patients (48 men; mean age, 72 +/- 11 years; range, 57-96 years) were treated. The type of stent graft used was Hemobahn/Viabahn in 42 (73.7%) cases, Wallgraft in 14 (24.5%) and Passager in one. The mean duration of hospitalization was 5 +/- 1.8 days (range, 3-11 days). No patients were lost from follow up (mean, 36 +/- 19.4 months; range, 6-96 months). Nine (16%) occlusions and six (10.5%) endoleaks occurred. The global limb salvage rate was 96.5% (55 of 57 PAA). Kaplan-Meier estimates for primary and secondary patency were 85.8% and 87.5% at one year and 82.3% and 87.5% at three years.
Endovascular treatment of PAA is feasible in selected patients. The main determinants of success are suitable aneurysm anatomy and dual antiplatelet postoperative therapy. Further studies are warranted to determine long-term outcomes of endovascular repair for PAA.
评估使用支架移植物腔内隔绝治疗腘动脉瘤(PAA)的可行性。
回顾性分析了 1999 年 12 月至 2007 年 12 月期间,法国三个血管科共 50 例患者(48 例男性;平均年龄 72 ± 11 岁;范围 57-96 岁)行 PAA 腔内隔绝术的临床资料。观察指标包括移植物通畅性和内漏。Kaplan-Meier 法用于计算主要和次要通畅率曲线。
共治疗 50 例患者的 57 个 PAA(42 例使用 Hemobahn/Viabahn,73.7%;14 例使用 Wallgraft,24.5%;1 例使用 Passager)。平均住院时间为 5 ± 1.8 天(范围 3-11 天)。无患者失访(平均随访 36 ± 19.4 个月;范围 6-96 个月)。9 例(16%)发生闭塞,6 例(10.5%)发生内漏。总体保肢率为 96.5%(55/57 个 PAA)。Kaplan-Meier 估计的 1 年和 3 年主要通畅率分别为 85.8%和 82.3%,次要通畅率分别为 87.5%和 87.5%。
腔内治疗 PAA 是可行的,适合于特定患者。成功的主要决定因素是合适的瘤体解剖和术后双联抗血小板治疗。需要进一步研究来确定 PAA 腔内修复的长期结果。