Contemporary Treatment of Popliteal Artery Aneurysms in 14 Countries: A Vascunet Report.

• Published in: European Journal of Vascular and Endovascular Surgery
• Main Authors: Grip, Olivia, Mani, Kevin, Altreuther, Martin, Bastos Gonçalves, Frederico, Beiles, Barry, Cassar, Kevin, Davidovic, Lazar, Eldrup, Nikolaj, Lattmann, Thomas, Laxdal, Elin, Menyhei, Gabor, Setacci, Carlo, Settembre, Nicla, Thomson, Ian, Venermo, Maarit, Björck, Martin
• Other Authors: 1Department of Surgical Sciences, Section of Vascular Surgery, Uppsala, Sweden. Electronic address: [e-mail]. 2Department of Surgical Sciences, Section of Vascular Surgery, Uppsala, Sweden. 3Department of Vascular Surgery, St Olavs Hospital, Trondheim, Norway. 4Centro Hospitalar Universitário de Lisboa Central - Hospital de Santa Marta, Lisbon, Portugal. 5Australian and New Zealand Society for Vascular Surgery, Melbourne, Australia. 6Vascular Unit, Department of Surgery, Mater Dei Hospital, Malta. 7Clinic for Vascular and Endovascular Surgery, Serbian Clinical Centre, Belgrade, Serbia. 8Department of Vascular Surgery, Copenhagen University Hospital Rigshospitalet, Denmark. 9Clinic of Vascular Surgery, Cantonal Hospital, Winterthur, Switzerland. 10Department of Vascular Surgery, Landspitalinn University Hospital, Reykjavik, Iceland. 11Department of Vascular Surgery Medical Centre, Pecs University, Pecs, Hungary. 12Università degli Studi di Siena, Siena, Italy. 13Department of Vascular and Endovascular Surgery, Nancy University Hospital, University of Lorraine, Nancy, France. 14Department of Surgical Sciences, Otago University, Dunedin, New Zealand. 15Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Elsevier 2020
• Subjects: Aneurysm – popliteal artery; Endovascular; Epidemiology; Open surgery; Registry; Slagæðargúlpur; Popliteal Artery; Aneurysm; New Zealand; Norway; Paa; Iceland
• Online Access: http://hdl.handle.net/2336/621608; https://doi.org/10.1016/j.ejvs.2020.07.005

To access publisher's full text version of this article click on the hyperlink below Objective: Popliteal artery aneurysm (PAA) is the second most common arterial aneurysm. Vascunet is an international collaboration of vascular registries. The aim was to study treatment and outcomes. Methods: This was a retrospective analysis of prospectively registered population based data. Fourteen countries contributed data (Australia, Denmark, Finland, France, Hungary, Iceland, Italy, Malta, New Zealand, Norway, Portugal, Serbia, Sweden, and Switzerland). Results: During 2012-2018, data from 10 764 PAA repairs were included. Mean values with between countries ranges in parenthesis are given. The incidence was 10.4 cases/million inhabitants/year (2.4-19.3). The mean age was 71.3 years (66.8-75.3). Most patients, 93.3%, were men and 40.0% were active smokers. The operations were elective in 73.2% (60.0%-85.7%). The mean pre-operative PAA diameter was 32.1 mm (27.3-38.3 mm). Open surgery dominated in both elective (79.5%) and acute (83.2%) cases. A medial surgical approach was used in 77.7%, and posterior in 22.3%. Vein grafts were used in 63.8%. Of the emergency procedures, 91% (n = 2 169, 20.2% of all) were for acute thrombosis and 9% for rupture (n = 236, 2.2% of all). Thrombosis patients had larger aneurysms, mean diameter 35.5 mm, and 46.3% were active smokers. Early amputation and death were higher after acute presentation than after elective surgery (5.0% vs. 0.7%; 1.9% vs. 0.5%). This pattern remained one year after surgery (8.5% vs. 1.0%; 6.1% vs. 1.4%). Elective open compared with endovascular surgery had similar one year amputation rates (1.2% vs. 0.2%; p = .095) but superior patency (84.0% vs. 78.4%; p = .005). Veins had higher patency and lower amputation rates, at one year compared with synthetic grafts (86.8% vs. 72.3%; 1.8% vs. 5.2%; both p < .001). The posterior open approach had a lower amputation rate (0.0% vs. 1.6%, p = .009) than the medial approach. Conclusion: Patients presenting with acute ...