Is Coverd Stent Graft Prone for Thrombosis: Case Report of Complication Faced on Follow-Up after Endovascular Management of Popliteal Artery Aneurysm

Introduction. It is rare for a popliteal artery aneurysm (PAA) to present with rupture. This case reports a longer-term success in the management of a large ruptured popliteal artery aneurysm with an endovascular approach, with a literature review of management of such cases. Case Report. An 80-year-old man presented to the accident and emergency department with pain and swelling behind the left knee and at the back of the thigh. An ultrasound scan and subsequent CT angiogram revealed a large 9.4 cm ruptured PAA. The patient had significant comorbidities deeming him unfit for a major surgical intervention of drainage of haematoma and exclusion bypass. Therefore, he underwent urgent endovascular treatment of the ruptured PAA with a covered stent graft. A follow-up duplex scan at 1 year showed a patent stent with no evidence of endoleak, and the patient remained asymptomatic. A clinical follow-up at 18- and 24-month postprocedure showed a patent stent graft and complete resolution of haematoma. Conclusion. Whilst open repair with exclusion bypass may still be a treatment of choice, an endovascular approach is both safe and effective in the management of a ruptured PAA in an unfit patient with an acceptable longer-term outcome.

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Adherence to instruction for use after endovascular repair of popliteal artery aneurysm

Vascular ◽

10.1177/17085381211007312 ◽

2021 ◽

pp. 170853812110073

Author(s):

Axel Wrede ◽

Leena Lehti ◽

Jonas Peter Eiberg ◽

Stefan Acosta

Keyword(s):

Stent Graft ◽

Endovascular Repair ◽

Popliteal Artery ◽

Artery Aneurysm ◽

Primary Patency ◽

Size Difference ◽

Stent Grafts ◽

Popliteal Artery Aneurysm ◽

One Year

Objectives Endovascular repair (ER) of popliteal artery aneurysm (PAA) is an alternative to open repair. However, there is no standardized protocol for when to opt for ER and the decision is therefore at the discretion of the clinician. This study aims to evaluate the adherence to the Instruction For Use (IFU) in patients undergoing ER for PAA and factors associated with stent graft patency at one year. Methods The adherence to IFU provided by the manufacturer in 55 patients treated with Gore Viabahn® Endoprosthesis with Heparin Bioactive Surface for PAA between 2009 and 2019 were retrospectively analyzed. Duplex follow-up was performed at 30 days and one year. Results The two groups of patients treated within ( n = 10) and not within ( n = 45) IFU did not differ in patient demographics, diagnostic assessment, treatment or outcome. Forty-five patients (81.8%) received stent graft placement with at least one deviation according to IFU. Distal oversizing >20% was the most frequent deviation against IFU ( n = 22, 40.0%). Primary patency at one year was 72%. Diameter size difference >1 mm between overlapping stent grafts (6/14 [43%], p = 0.013) and renal insufficiency (5/12 [42%], p = 0.0086) were associated with lower primary patency at one year. Age-adjusted analysis of tortuosity index (HR 1.78/SD, 95% CI 1.17–2.71; p = 0.0071) and maximal PAA angle (HR 1.73/SD, 95% CI 1.018–2.95; p = 0.043) were associated with major amputation/mortality at end of follow-up. Conclusion The majority of patients undergoing ER for PAA were not treated within IFU. Diameter size difference >1 mm between overlapping stent grafts was associated with a higher loss of primary patency at one year. Multi-center studies with larger sample size and long-term follow up of patency are warranted.

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Foot drop with a popliteal artery aneurysm due to heroin use: A case report

Turkish Journal of Physical Medicine and Rehabilitation ◽

10.5606/tftrd.2018.2124 ◽

2018 ◽

Vol 64 (3) ◽

pp. 284-287

Author(s):

Ayşe Nur Bardak

Keyword(s):

Case Report ◽

Popliteal Artery ◽

Artery Aneurysm ◽

Foot Drop ◽

Heroin Use ◽

Popliteal Artery Aneurysm

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Behçet's Disease and Popliteal Artery Aneurysm: a Case Report and Review of the Literature

EJVES Extra ◽

10.1053/ejvx.2001.0077 ◽

2001 ◽

Vol 2 (2) ◽

pp. 25-28

Author(s):

H. Akar ◽

T. Akpolat ◽

F. Kolbakir ◽

C. Konuralp ◽

I. Akpolat ◽

...

Keyword(s):

Case Report ◽

Behçet’S Disease ◽

Popliteal Artery ◽

Behcet’S Disease ◽

Behçet's Disease ◽

Artery Aneurysm ◽

Review Of The Literature ◽

Behcet's Disease ◽

Popliteal Artery Aneurysm

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Rupture of a Giant Popliteal Artery Aneurysm, Associated with Type III Aortic Dissection: A Case Report

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2005.02.036 ◽

2005 ◽

Vol 30 (1) ◽

pp. 111

Author(s):

V. Chervenkoff ◽

V. Govedarsky ◽

D. Maximov ◽

A. Daskalov ◽

V. Stoinova

Keyword(s):

Case Report ◽

Aortic Dissection ◽

Popliteal Artery ◽

Artery Aneurysm ◽

Popliteal Artery Aneurysm ◽

Type Iii

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Intimal sarcoma of the popliteal artery presenting as popliteal artery aneurysm: A rare case report

Indian Journal of Vascular and Endovascular Surgery ◽

10.4103/ijves.ijves_37_18 ◽

2018 ◽

Vol 5 (3) ◽

pp. 208

Author(s):

MahmoodDhahir Al-Mendalawi

Keyword(s):

Case Report ◽

Popliteal Artery ◽

Rare Case ◽

Artery Aneurysm ◽

Intimal Sarcoma ◽

Popliteal Artery Aneurysm ◽

Rare Case Report

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How to proceed with a patent popliteal artery aneurysm below the chronic superficial femoral artery occlusion?

Perspectives in Surgery ◽

10.33699/pis.2020.99.8.356-360 ◽

2020 ◽

Vol 99 (8) ◽

Keyword(s):

Femoral Artery ◽

Superficial Femoral Artery ◽

Popliteal Artery ◽

Artery Aneurysm ◽

Artery Occlusion ◽

Mural Thrombus ◽

Popliteal Artery Aneurysm ◽

Femoral Artery Occlusion ◽

Aneurysm Thrombosis

Introduction: The indications for popliteal artery aneurysm treatment are clear. In aneurysms with patent inflow and outflow arteries, the risk of peripheral embolisation from a mural thrombus is high and the treatment, mostly a vascular intervention, is focused on preventing this extremity- threatening complication. It is unclear, however, how high the risk of peripheral embolisation is and how to proceed with a patent popliteal artery aneurysm fed by the deep femoral artery when the superficial femoral artery is chronically occluded. Methods: All patients diagnosed with popliteal artery aneurysm between 2015 and 2019 were searched in the database of the Department of Surgery II of University Hospital Olomouc. Patients with a patent popliteal artery aneurysm and chronic superficial femoral artery occlusion in the ipsilateral extremity were selected. Results: We diagnosed 66 patients with 85 popliteal artery aneurysms. Four patients had a patent popliteal artery aneurysm and chronic superficial femoral artery occlusion in the ipsilateral extremity. In these patients, conservative treatment was indicated after the diagnosis was determined. In three patients, no clinically obvious complication of the popliteal artery aneurysm occurred. In one patient, popliteal artery aneurysm thrombosis occurred after a follow-up of 21 months, leading to a shortening of his calf claudication distance and limiting the patient. Conclusion: Our experience with this small group of patients shows the possibility of primary conservative treatment in patients with a patent popliteal artery aneurysm below the chronic superficial femoral artery occlusion site. Aneurysm thrombosis can be expected during follow-up. Patients in whom the thrombosis leads to limitations are indicated for surgical intervention. The risk of peripheral embolisation from the mural thrombus cannot be excluded with certainty. Further studies involving large groups of patients are needed to provide a more precise recommendation.

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A Matched Case-Control Study on Open and Endovascular Treatment of Popliteal Artery Aneurysms

Scandinavian Journal of Surgery ◽

10.1177/1457496917748230 ◽

2018 ◽

Vol 107 (3) ◽

pp. 236-243 ◽

Cited By ~ 4

Author(s):

W. Dorigo ◽

A. Fargion ◽

F. Masciello ◽

G. Piffaretti ◽

G. Pratesi ◽

...

Keyword(s):

Endovascular Repair ◽

Popliteal Artery ◽

Open Repair ◽

Artery Aneurysm ◽

Popliteal Artery Aneurysm ◽

Matched Case ◽

Repair Group ◽

Matched Case Control Study ◽

Control Study

Objective: To compare early and late results of open and endovascular management of popliteal artery aneurysm in a retrospective single-center matched case-control study Methods: From 1981 to 2015, 309 consecutive interventions for popliteal artery aneurysm were performed in our institution, in 59 cases with endovascular repair and in 250 cases with open repair. Endovascular repair was preferred in older asymptomatic patients, while open repair was offered more frequently to patients with a thrombosed popliteal artery aneurysm and a poor run-off status. A one-to-one coarsened exact matching on the basis of the baseline demographic, clinical, and anatomical covariates significantly different between the two treatment options was performed and two equivalent groups of 56 endovascular repairs and open repairs were generated. The two groups were compared in terms of perioperative results with χ2 test and of follow-up outcomes with the Kaplan–Meier curves and log-rank test. Results: There were no differences between the two groups in terms of perioperative outcomes. Median duration of follow-up was 38 months. Five-year survival rates were 94% in endovascular repair group and 89.5% in open repair group (p = 0.4, log-rank 0.6). Primary patency rates at 1, 3, and 5 years were 81%, 78%, and 72% in endovascular repair group and 82.5%, 80%, and 64% in open repair group (p = 0.8, log-rank 0.01). Freedom from reintervention at 5 years was 65.5% in endovascular repair group and 76% in open repair group (p = 0.2, log-rank 1.2). Secondary patency at 1, 3, and 5 years was 94%, 86%, and 74% in endovascular repair group, and 94%, 89%, and 71% in open repair group, respectively (p = 0.9, log-rank 0.01). The rates of limb preservation at 5 years were 94% in endovascular repair group and 86.4% in open repair group (p = 0.3, log-rank 0.8). Conclusion: Open repair and endovascular repair of popliteal artery aneurysms provided in this retrospective single-center experience similar perioperative and follow-up results in equivalent groups of patients.

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