34 - Complications of Endovascular Repair of Popliteal Artery Aneurysms

Abstract

Popliteal artery aneurysms occur at an incidence of 7.39 per 100,000 people, accounting for 80% of peripheral artery aneurysms. Historically they have been treated by open surgical repair, with cumulative patency rates of 80% at 3 years; but increasingly, endovascular repair is now being undertaken with similar patency rates of 70% at 4 years. Endovascular repair of popliteal aneurysms has unique planning and procedural considerations, including evaluation of size discrepancies between proximal/distal seal zones, management of concomitant occlusive disease, lack of dedicated devices, and access vessel challenges. Postoperatively, specific attention must be paid to both the aneurysm seal, with potential for endoleaks, and the risk of stenosis or occlusion of the stent grafts, especially if concomitant occlusive disease is present. Much remains to be determined regarding best practices for endovascular management of popliteal artery aneurysms, but, with what is already understood, high rates of technical success can be achieved, as can acceptable mid- to long-term patency.