The Strict Adherence to the Indications for Endovascular Repair of the Popliteal Artery Aneurysm-Guaranteed the long term Success in the Single Center Experience

Abstract

Introduction: Endovascular exclusion of popliteal artery aneurysm is an attractive and noninvasive alternative to the classical open vascular surgery treatment. It provides an opportunity for treatment of patients with comorbidities who have a high risk associated with an open surgery procedure. Endovascular procedures alleviates complications related with open surgery, in particular it reduces pain and convalescence time. Comparable to the classical open vascular surgery method, the results of endovascular treatment induce vascular surgeons to prefer the less invasive option. An important aspect affecting the operation results is proper planning and adherence to the indications for endovascular procedures. The basic criteria we have approved were: proximal(1) and distal(2) landing zone off 15mm, oversizing within limits of 10-30%(3) and patency of at least one artery of the below knee arteries that supplies the arch of the foot. The aim of the study was to assess the legitimacy of compliance with the qualification requirements for the procedure of endovascular repair of the popliteal artery aneurysm and the assessment of the evident effects of departures or bending the eligibility criteria for this procedure. Methods: In the examined group of 43 patients, who underwent Viabahn stent graft implantation, 31 patients met all 4 eligibility criteria. The remaining 12 (27,90%) patients did not meet at least one, of the 4 stent graft implantation criteria, of which 4 (9,30%) did not meet two criteria. All completed procedures ended with immediate success. Patients were discharged on anti-aggregation treatment with the recommendation of control at intervals of 1, 3, 6 and 12 months. Results: All patients were monitored for the average follow up of 38 months. There were no complications in the group of patients qualified for surgery according to our Clinic guidelines. Conversely, in the group of patients in which not all the eligibility criteria for stent graft implantation were met, 3 (25 %) cases of stent graft clot were found within follow up period. In addition, there were 2(16,67%) cases of the stent graft migration to the aneurysm sac without thrombosis and 2(16,67%) cases of leakage of the stent graft within peripheral embolism. Conclusion: Complications after stent graft implantation in the popliteal artery aneurysm were observed exclusively in the group of patients without all eligibility criteria for the endovascular procedure. Therefore strict adherence to the eligibility criteria for popliteal artery aneurysm surgery is crucial for the successful outcome of the operation and post-operational recovery. Disclosure: Nothing to disclose