scholarly journals Successful Endovascular Repair of a Ruptured Popliteal Artery Aneurysm: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Duncan Muir ◽  
Sachin R. Kulkarni
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Stent Graft ◽  
Popliteal Artery ◽  
Case Reports ◽  
Artery Aneurysm ◽  
Popliteal Artery Aneurysm ◽  
Ct Angiogram ◽  
Endovascular Approach

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.

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

Vascular ◽  
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.

Unusual source of fever: the curious case of an infected arterial stent graft presenting as a ruptured popliteal artery aneurysm

2021 ◽  
Vol 14 (2) ◽  
pp. e239272
Author(s):  
Emily Kate Edwina Schmidt ◽  
Sherab Bhutia
Keyword(s):  
Stent Graft ◽  
Popliteal Artery ◽  
Graft Infection ◽  
Artery Aneurysm ◽  
Previous Treatment ◽  
Large Collection ◽  
Popliteal Artery Aneurysm ◽  
Ct Angiogram ◽  
Initial Intervention ◽  
History Of

A 71-year-old man presented to the emergency department with a 1-week history of lethargy, general malaise and intermittent high fever. He had presented 18 months ago, and again 12 months earlier with similar symptoms. On this third presentation, the fever was accompanied by right thigh swelling and pain. The patient was referred to the vascular surgeons with concern regarding an infected vascular stent graft from previous treatment of popliteal artery aneurysms (PAA) 8 years earlier. CT angiogram demonstrated a collapsed right PAA sac with a large collection, consistent with ruptured PAA, and a single gas bubble around the indwelling stent graft. The patient recovered well after a course of antibiotics and surgical explantation of the graft. Infection is a potential complication of any implanted arterial advice, and needs to be considered even years after initial intervention and with no localising symptoms.

Ruptured popliteal artery aneurysms

Vascular ◽  
2019 ◽  
Vol 27 (4) ◽  
pp. 430-447 ◽  
Author(s):  
James Akman ◽  
Emmanuel Katsogridakis ◽  
George A Antoniou
Keyword(s):  
Popliteal Artery ◽  
Open Surgery ◽  
Case Reports ◽  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Surgical Reconstruction ◽  
Acute Limb Ischemia ◽  
Perioperative Mortality ◽  
Popliteal Artery Aneurysm

BackgroundRupture is a recognised complication of ruptured popliteal artery aneurysms that requires emergency intervention. There is little evidence collating the presentation, intervention and outcomes of ruptured popliteal artery aneurysms.ObjectiveThe primary aim of this study was to deduce the sequelae following different management modalities of ruptured popliteal artery aneurysm.MethodsWe performed a systematic review of all available cases reports of ruptured popliteal artery aneurysms in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis Protocol.ResultsWe identified 48 cases taken from 35 case reports and series. Men were more commonly affected ( n = 96%), and mean age was 71 years. Acute limb ischemia was the commonest presentation (32%) whilst incidental deep vein thrombosis was found in 43% of patients. The mean aneurysm size was 8.2 cm (range, 2.7 to 13.3 cm). Management consisted of open surgery (58%), endovascular treatment (25%) and ‘other’ treatment (evacuation of haematoma, ligation of aneurysm, amputation or palliation) (17%). The perioperative mortality rate in the whole cohort was 13%. Perioperative mortality was similar between comparing the open and endovascular surgery groups. Re-intervention rate amongst endovascular patients was 25% over an average follow-up period of 14 months. There was one re-intervention in the re-constructive group (3%) over a follow-up period of 17 months and none in the ‘other’ group.ConclusionPopliteal artery aneurysm rupture is a serious complication associated with significant morbidity and mortality. Open surgical reconstruction and endovascular repair are both feasible for the treatment of ruptured popliteal artery aneurysms; however, open surgery is less likely to require further re-intervention.

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

EJVES Extra ◽  
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

Popliteal Artery Aneurysm Treated with a Minimally Invasive Endovascular Approach: An Initial Report

1998 ◽  
Vol 5 (1) ◽  
pp. 60-63 ◽  
Author(s):  
David Rosenthal ◽  
Colby P. Atkins ◽  
Frederick W. Shuler ◽  
Hilde S. Jerius ◽  
Michael D. Clark ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Saphenous Vein ◽  
Popliteal Artery ◽  
Artery Aneurysm ◽  
Wound Complications ◽  
Popliteal Artery Aneurysm ◽  
Vein Bypass ◽  
Endovascular Approach ◽  
In Situ Bypass

Purpose: To report a minimally invasive approach to popliteal artery aneurysm (PAA) treatment. Methods and Results: A 48-year-old male with a 3-cm PAA was treated electively with an endovascular in situ saphenous vein bypass and transluminal antegrade coil embolization of the PAA prior to completion of the proximal anastomosis. Two short incisions at the anastomosis sites resulted in no wound complications, and the patient was discharged after 2 days. After 14 months of follow-up, the patient is asymptomatic with continued patency of the in situ bypass and occlusion of the PAA. Conclusions: This endovascular approach for minimally invasive femoropopliteal in situ saphenous vein bypass grafting appears feasible for treatment of PAAs. This method may reduce the rate of wound complications attending classic open in situ bypass grafts.

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