OBJECTIVES: A retrospective study to evaluate the treatment, long term follow-up and factors affecting revascularization results particularly in regard to clinical presentation and prosthetic materials used after 20 years of experience. MATERIALS AND METHODS: Between 1974 and September 1995 there were 67 popliteal aneurysms in 58 patients. Three patients underwent a primary amputation because of irreversible ischaemia and 3 patients a surgical sympathectomy. Operative repair was performed in 61 cases: as an emergency in 9 (14.7%) limbs and as an elective procedure in 52 (85.3%) limbs. Graft replacement was performed employing polytetrafluoroethylene (PTFE) grafts in 34 (55.7%) cases 13 of which with Ringed PTFE, autogenous saphenous vein in 10 (16.4%) cases and Dacron in 17 (27.9%). RESULTS: The cumulative primary patency (CP) and limb salvage rate (LS) at 10 years were 75.1% and 83.3% respectively. We divided the patients into two groups: asymptomatic (Group I) and symptomatic with limb threatening ischemia (Group II). At 10 years the CP in Group I and II were 78.2% vs 67.2% respectively (p < 0.05 at 18 months) and the LS 87.4% vs 74.6% (p < 0.05). There was no statistical difference in terms of CP and LS rate between saphenous vein and PTFE. The use of PTFE grafts avoided harvesting of the long saphenous vein; this resulted in a significantly reduced operation time (135 +/- 18.6 vs 195 +/- 22.4 minutes, p < 0.001) and length of stay (7.4 vs 8.8 days, p < 0.02). CONCLUSIONS: We conclude that elective repair is indicated in all patients with popliteal aneurysm > or = 2 cm to avoid a critical ischemia with poorer results in terms of CP and LS. In the last 3 years our technique of choice is the exclusion of the aneurysm with a short PTFE bypass with good long-term of CP and LS rates.
OBJECTIVES: A retrospective study to evaluate the treatment, long term follow-up and factors affecting revascularization results particularly in regard to clinical presentation and prosthetic materials used after 20 years of experience. MATERIALS AND METHODS: Between 1974 and September 1995 there were 67 popliteal aneurysms in 58 patients. Three patients underwent a primary amputation because of irreversible ischaemia and 3 patients a surgical sympathectomy. Operative repair was performed in 61 cases: as an emergency in 9 (14.7%) limbs and as an elective procedure in 52 (85.3%) limbs. Graft replacement was performed employing polytetrafluoroethylene (PTFE) grafts in 34 (55.7%) cases 13 of which with Ringed PTFE, autogenous saphenous vein in 10 (16.4%) cases and Dacron in 17 (27.9%). RESULTS: The cumulative primary patency (CP) and limb salvage rate (LS) at 10 years were 75.1% and 83.3% respectively. We divided the patients into two groups: asymptomatic (Group I) and symptomatic with limb threatening ischemia (Group II). At 10 years the CP in Group I and II were 78.2% vs 67.2% respectively (p < 0.05 at 18 months) and the LS 87.4% vs 74.6% (p < 0.05). There was no statistical difference in terms of CP and LS rate between saphenous vein and PTFE. The use of PTFE grafts avoided harvesting of the long saphenous vein; this resulted in a significantly reduced operation time (135 +/- 18.6 vs 195 +/- 22.4 minutes, p < 0.001) and length of stay (7.4 vs 8.8 days, p < 0.02). CONCLUSIONS: We conclude that elective repair is indicated in all patients with popliteal aneurysm > or = 2 cm to avoid a critical ischemia with poorer results in terms of CP and LS. In the last 3 years our technique of choice is the exclusion of the aneurysm with a short PTFE bypass with good long-term of CP and LS rates.
Authors: Rodrigo Nóbrega Bandeira; Daniel Guimarães Cacione; Francisco Chavier Vieira Bandeira; Ariane de Sousa Pelissoni; Cibele Ohany Nogueira Leite; Luis Carlos Uta Nakano Journal: J Vasc Bras Date: 2018 Jan-Mar