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

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.