Outcome of endovascular repair of popliteal artery aneurysm using the Viabahn endoprosthesis

Karan Garg, Caron B. Rockman, Billy J. Kim, Glenn R. Jacobowitz, Thomas S. Maldonado, Mark A. Adelman, Frank J. Veith, Neal S. Cayne

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Objective: This study reviews a single-center experience of endovascular popliteal aneurysm (PAA) repair. Methods: A retrospective review was performed to identify all endovascular PAA repairs performed between September 2004 and January 2011. Results: We identified 21 patients (mean age, 74 ± 9 years, 91% men) with PAAs (mean size, 2.89 ± 1.0 cm) in 26 limbs, of which 38% were symptomatic. All patients underwent endovascular repair with a Viabahn covered stent graft (W. L. Gore & Assoc, Inc, Flagstaff, Ariz). Postoperatively, all patients were maintained on antiplatelet therapy with clopidogrel or aspirin, or both. Mean follow-up was 22 ± 17 months (range, 1-57 months). One patient with one aneurysm was lost to follow-up. Primary and secondary patencies were both 91.2% at 1 year and were 85.5% and 91.2%, respectively, at 2 years. The limb salvage rate was 100%. Four stent graft failures occurred at a mean of 12.3 ± 11 months. One technical failure due to stent graft infolding required conversion to an open femoral-popliteal bypass. Three additional graft failures occurred in patients with poor (single-vessel) runoff. Compared with patients with two- or three-vessel runoff, the graft failure rate in patients with single-vessel runoff was statistically significant (P =.02). Two of the graft failures were successfully treated with open thrombectomy, and one required a tibial artery bypass for limb salvage. Conclusions: Endovascular repair of PAAs is feasible and has acceptable midterm patency rates. Poor distal runoff predicted graft failure.

Original languageEnglish (US)
Pages (from-to)1647-1653
Number of pages7
JournalJournal of Vascular Surgery
Volume55
Issue number6
DOIs
StatePublished - Jun 2012
Externally publishedYes

Fingerprint

Popliteal Artery
Aneurysm
Transplants
Stents
Limb Salvage
clopidogrel
Tibial Arteries
Thrombectomy
Lost to Follow-Up
Thigh
Aspirin
Extremities

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Garg, K., Rockman, C. B., Kim, B. J., Jacobowitz, G. R., Maldonado, T. S., Adelman, M. A., ... Cayne, N. S. (2012). Outcome of endovascular repair of popliteal artery aneurysm using the Viabahn endoprosthesis. Journal of Vascular Surgery, 55(6), 1647-1653. https://doi.org/10.1016/j.jvs.2011.12.059

Outcome of endovascular repair of popliteal artery aneurysm using the Viabahn endoprosthesis. / Garg, Karan; Rockman, Caron B.; Kim, Billy J.; Jacobowitz, Glenn R.; Maldonado, Thomas S.; Adelman, Mark A.; Veith, Frank J.; Cayne, Neal S.

In: Journal of Vascular Surgery, Vol. 55, No. 6, 06.2012, p. 1647-1653.

Research output: Contribution to journalArticle

Garg, K, Rockman, CB, Kim, BJ, Jacobowitz, GR, Maldonado, TS, Adelman, MA, Veith, FJ & Cayne, NS 2012, 'Outcome of endovascular repair of popliteal artery aneurysm using the Viabahn endoprosthesis', Journal of Vascular Surgery, vol. 55, no. 6, pp. 1647-1653. https://doi.org/10.1016/j.jvs.2011.12.059
Garg, Karan ; Rockman, Caron B. ; Kim, Billy J. ; Jacobowitz, Glenn R. ; Maldonado, Thomas S. ; Adelman, Mark A. ; Veith, Frank J. ; Cayne, Neal S. / Outcome of endovascular repair of popliteal artery aneurysm using the Viabahn endoprosthesis. In: Journal of Vascular Surgery. 2012 ; Vol. 55, No. 6. pp. 1647-1653.
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abstract = "Objective: This study reviews a single-center experience of endovascular popliteal aneurysm (PAA) repair. Methods: A retrospective review was performed to identify all endovascular PAA repairs performed between September 2004 and January 2011. Results: We identified 21 patients (mean age, 74 ± 9 years, 91{\%} men) with PAAs (mean size, 2.89 ± 1.0 cm) in 26 limbs, of which 38{\%} were symptomatic. All patients underwent endovascular repair with a Viabahn covered stent graft (W. L. Gore & Assoc, Inc, Flagstaff, Ariz). Postoperatively, all patients were maintained on antiplatelet therapy with clopidogrel or aspirin, or both. Mean follow-up was 22 ± 17 months (range, 1-57 months). One patient with one aneurysm was lost to follow-up. Primary and secondary patencies were both 91.2{\%} at 1 year and were 85.5{\%} and 91.2{\%}, respectively, at 2 years. The limb salvage rate was 100{\%}. Four stent graft failures occurred at a mean of 12.3 ± 11 months. One technical failure due to stent graft infolding required conversion to an open femoral-popliteal bypass. Three additional graft failures occurred in patients with poor (single-vessel) runoff. Compared with patients with two- or three-vessel runoff, the graft failure rate in patients with single-vessel runoff was statistically significant (P =.02). Two of the graft failures were successfully treated with open thrombectomy, and one required a tibial artery bypass for limb salvage. Conclusions: Endovascular repair of PAAs is feasible and has acceptable midterm patency rates. Poor distal runoff predicted graft failure.",
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AU - Jacobowitz, Glenn R.

AU - Maldonado, Thomas S.

AU - Adelman, Mark A.

AU - Veith, Frank J.

AU - Cayne, Neal S.

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N2 - Objective: This study reviews a single-center experience of endovascular popliteal aneurysm (PAA) repair. Methods: A retrospective review was performed to identify all endovascular PAA repairs performed between September 2004 and January 2011. Results: We identified 21 patients (mean age, 74 ± 9 years, 91% men) with PAAs (mean size, 2.89 ± 1.0 cm) in 26 limbs, of which 38% were symptomatic. All patients underwent endovascular repair with a Viabahn covered stent graft (W. L. Gore & Assoc, Inc, Flagstaff, Ariz). Postoperatively, all patients were maintained on antiplatelet therapy with clopidogrel or aspirin, or both. Mean follow-up was 22 ± 17 months (range, 1-57 months). One patient with one aneurysm was lost to follow-up. Primary and secondary patencies were both 91.2% at 1 year and were 85.5% and 91.2%, respectively, at 2 years. The limb salvage rate was 100%. Four stent graft failures occurred at a mean of 12.3 ± 11 months. One technical failure due to stent graft infolding required conversion to an open femoral-popliteal bypass. Three additional graft failures occurred in patients with poor (single-vessel) runoff. Compared with patients with two- or three-vessel runoff, the graft failure rate in patients with single-vessel runoff was statistically significant (P =.02). Two of the graft failures were successfully treated with open thrombectomy, and one required a tibial artery bypass for limb salvage. Conclusions: Endovascular repair of PAAs is feasible and has acceptable midterm patency rates. Poor distal runoff predicted graft failure.

AB - Objective: This study reviews a single-center experience of endovascular popliteal aneurysm (PAA) repair. Methods: A retrospective review was performed to identify all endovascular PAA repairs performed between September 2004 and January 2011. Results: We identified 21 patients (mean age, 74 ± 9 years, 91% men) with PAAs (mean size, 2.89 ± 1.0 cm) in 26 limbs, of which 38% were symptomatic. All patients underwent endovascular repair with a Viabahn covered stent graft (W. L. Gore & Assoc, Inc, Flagstaff, Ariz). Postoperatively, all patients were maintained on antiplatelet therapy with clopidogrel or aspirin, or both. Mean follow-up was 22 ± 17 months (range, 1-57 months). One patient with one aneurysm was lost to follow-up. Primary and secondary patencies were both 91.2% at 1 year and were 85.5% and 91.2%, respectively, at 2 years. The limb salvage rate was 100%. Four stent graft failures occurred at a mean of 12.3 ± 11 months. One technical failure due to stent graft infolding required conversion to an open femoral-popliteal bypass. Three additional graft failures occurred in patients with poor (single-vessel) runoff. Compared with patients with two- or three-vessel runoff, the graft failure rate in patients with single-vessel runoff was statistically significant (P =.02). Two of the graft failures were successfully treated with open thrombectomy, and one required a tibial artery bypass for limb salvage. Conclusions: Endovascular repair of PAAs is feasible and has acceptable midterm patency rates. Poor distal runoff predicted graft failure.

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