Repair of Femoral and Popliteal Artery Aneurysms

2020 ◽  
Author(s):  
Patrick J. O'Hara
Keyword(s):  
Femoral Artery ◽  
Endovascular Repair ◽  
Popliteal Artery ◽  
Operative Technique ◽  
Surgical Repair ◽  
Preoperative Evaluation ◽  
Artery Aneurysm ◽  
Outcome Evaluation ◽  
Elective Repair ◽  
Operative Planning

Femoral and popliteal artery aneurysms constitute most peripheral aneurysms. In general, with both femoral and popliteal artery aneurysms, elective repair and reconstruction tend to be associated with significantly better postoperative outcomes than emergency repair undertaken after a limb-threatening complication. Specific treatment decisions may be influenced by the presence or absence of symptoms of aneurysmal disease. For femoral artery aneurysms, this chapter presents the preoperative evaluation, operative planning, operative technique (endovascular repair, ultrasound-guided compression, and open surgical repair), and outcome evaluation. For popliteal aneurysms, this chapter discusses the preoperative evaluation, operative planning (indications for repair and preoperative arterial thrombolysis), operative technique (open vs. endovascular repair), and outcome evaluation (dependent on whether surgical or endovascular).  This review contains 15 figures, 9 tables, and 41 references. Keywords:Lower extremity aneurysm, popliteal artery aneurysm, femoral artery aneurysm, surgical repair, endovascular repair, thrombosis, embolization

Repair of Femoral and Popliteal Artery Aneurysms

2020 ◽  
Author(s):  
Patrick J. O'Hara
Keyword(s):  
Femoral Artery ◽  
Endovascular Repair ◽  
Popliteal Artery ◽  
Operative Technique ◽  
Surgical Repair ◽  
Preoperative Evaluation ◽  
Artery Aneurysm ◽  
Outcome Evaluation ◽  
Elective Repair ◽  
Operative Planning

Femoral and popliteal artery aneurysms constitute most peripheral aneurysms. In general, with both femoral and popliteal artery aneurysms, elective repair and reconstruction tend to be associated with significantly better postoperative outcomes than emergency repair undertaken after a limb-threatening complication. Specific treatment decisions may be influenced by the presence or absence of symptoms of aneurysmal disease. For femoral artery aneurysms, this chapter presents the preoperative evaluation, operative planning, operative technique (endovascular repair, ultrasound-guided compression, and open surgical repair), and outcome evaluation. For popliteal aneurysms, this chapter discusses the preoperative evaluation, operative planning (indications for repair and preoperative arterial thrombolysis), operative technique (open vs. endovascular repair), and outcome evaluation (dependent on whether surgical or endovascular).  This review contains 15 figures, 9 tables, and 41 references. Keywords:Lower extremity aneurysm, popliteal artery aneurysm, femoral artery aneurysm, surgical repair, endovascular repair, thrombosis, embolization

Open Procedures for Renovascular Disease

2012 ◽  
Author(s):  
Christopher J. Godshall ◽  
Racheed J. Ghanami ◽  
Kimberley J Hansen
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Operative Technique ◽  
Preoperative Evaluation ◽  
Outcome Evaluation ◽  
Renovascular Disease ◽  
Free Survival ◽  
Operative Planning ◽  
Relationship Of ◽  
The Relationship

The open procedures most commonly performed to treat renovascular disease are aortorenal bypass, renal artery thromboendarterectomy, and renal artery reimplantation. This review discusses preoperative evaluation, operative planning, and the operative technique of the aforementioned procedures. In addition, outcome evaluation is described, including hypertension response, renal function response, and the relationship of these to dialysis-free survival. A table provides the recommended principles for contemporary surgical management of renovascular disease. Figures show various types of bypass procedures. This review contains 10 references plus additional sources of recommended reading.

scholarly journals Endovascular Repair of Popliteal Artery Aneurysm: A Comparison of Outcomes with Contemporary Open Surgical Repair

2013 ◽  
Vol 58 (5) ◽  
pp. 1431
Author(s):  
Ying Huang ◽  
Peter Gloviczki ◽  
Gustavo S. Oderich ◽  
Audra A. Duncan ◽  
Manju Kalra ◽  
...  
Keyword(s):  
Endovascular Repair ◽  
Popliteal Artery ◽  
Surgical Repair ◽  
Artery Aneurysm ◽  
Open Surgical Repair ◽  
Popliteal Artery Aneurysm

scholarly journals Endograft connector technique to treat popliteal artery aneurysm in a morbid obese patient

Vascular ◽  
2014 ◽  
Vol 23 (2) ◽  
pp. 165-169 ◽  
Author(s):  
Felice Pecoraro ◽  
Guido Bajardi ◽  
Ettore Dinoto ◽  
Gaetano Vitale ◽  
Mario Bellisi ◽  
...  
Keyword(s):  
Obese Patient ◽  
Popliteal Artery ◽  
Surgical Repair ◽  
Artery Aneurysm ◽  
X Rays ◽  
Dacron Graft ◽  
Popliteal Artery Aneurysm ◽  
Bypass Patency ◽  
Morbid Obese ◽  
Tomography Scan

Surgical repair of popliteal artery aneurysm in morbid obese patients poses additional challenges. We report a morbid obese patient who had a 59 mm right popliteal artery aneurysm which was successfully treated with the endograft connector technique. This technique was used to perform the distal anastomosis of the below-knee femoro-popliteal bypass. A 10 mm Dacron graft was used as a main graft bypass and an 11 mm/10 cm stentgraft as endograft connector. Following the respective tunnel of the Dacron graft, an end-to-side proximal anastomosis was performed at distal femoral artery. The aneurysm exclusion was obtained through a proximal and a distal ligation. Postoperative duplex showed adequate bypass patency. Knee x-rays demonstrated no signs of stent kinking/fractures. The postoperative course was uneventful and the patient was discharged home on fourth day post operative. The six-month computed tomography scan and the 12-month duplex control showed a patent bypass with no signs of stenosis.

Open Esophageal Procedures

2014 ◽  
Author(s):  
Cameron D Wright
Keyword(s):  
Preoperative Evaluation ◽  
Transhiatal Esophagectomy ◽  
Outcome Evaluation ◽  
Hiatal Hernia Repair ◽  
Operative Techniques ◽  
Esophageal Diseases ◽  
Ivor Lewis ◽  
Ivor Lewis Esophagectomy ◽  
Zenker Diverticulum ◽  
Operative Planning

The growing stature of minimally invasive approaches to esophageal diseases does not diminish the importance of the equivalent open approaches. This chapter describes common open operations performed to excise Zenker diverticulum, to manage complex gastroesophageal reflux disease, and to resect esophageal and proximal gastric tumors. For each of these open procedures, the preoperative evaluation, operative planning, steps of the operative techniques, postoperative care, complications, and outcome evaluation are described. Over two dozen figures show many of the operative steps for a cricopharyngeal myotomy and excision of Zenker diverticulum, a transthoracic hiatal hernia repair, a transhiatal esophagectomy, Ivor-Lewis esophagectomy, and a left thoracoabdominal esophagogastrectomy. This chapter contains 27 figures, 12 tables, 13 references, 5 Board-styled MCQs, and 1 Teaching Slide Set.

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

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.

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

2018 ◽  
Vol 107 (3) ◽  
pp. 236-243 ◽  
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.

Femoral Artery Aneurysm Repair in a Patient With a Fibrillin-2 Mutation

2018 ◽  
Vol 52 (7) ◽  
pp. 583-586
Author(s):  
Thomas Ratschiller ◽  
Hannes Müller ◽  
Thomas Schachner ◽  
Franz Fellner ◽  
Gregor Sulzbacher ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Stent Graft ◽  
Femoral Artery ◽  
Surgical Repair ◽  
Artery Aneurysm ◽  
Arterial Reconstruction ◽  
Open Surgical Repair ◽  
Gene Encoding ◽  
Graft Placement ◽  
Aneurysm Repair

Degenerative femoral artery aneurysms are uncommon and often associated with aneurysm in other distributions. We report a case of a 68-year-old man with multianeurysmal disease involving the aorta, iliac, femoral, and popliteal arteries managed interdisciplinary by stent-graft placement and open surgical repair. Genetic testing revealed a variant in the FBN2 gene encoding fibrillin-2, an important component of microfibrils. We detail arterial reconstruction of the femoral artery and discuss incidence, diagnosis, and therapy of femoral artery aneurysms.

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