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Zenunaj GLADIOLI, Luca TRAINA, Pierfilippo ACCIARRI, Francesco MASCOLI
Unit of Vascular and Endovascular Surgery, S. Anna University Hospital, Ferrara, Italy
BACKGROUND: Endovascular repair of popliteal artery aneurysm (Paa) has emerged as a less invasive approach compared to the open repair, and recently there has been an increase in the number of endovascular procedures in many countries. We evaluated the outcomes in patients with PAA treated by endovascular and open approach during the same frame time at our institute.
METHODS: A retrospective review to identify PAAs treated at our institute between January 2011 and January 2014 was performed.
RESULTS: We identified 46 PAAs in 41 patients. Thirty PAAs underwent to open repair and 16 PAAs to endovascular repair. The median followup was 22 months (range 15-30 months) and 15 months (range 9-30 months) for the open and endovascular group respectively. Primary patency, limb salvage 30 days for open and endovascular group were 97% vs. 100% and 96% vs. 100% respectively. Median length of hospitalization was 7 vs. 2 days in the open and endovascular group respectively. In the open group the primary patency was at 1 and 2 years were 93%, in the secondary it was patency 100%, limb salvage 97%, survival rate 100%. In the endovascular group, primary patency was at 1 year 63%, secondary patency 100%, limb salvage 94%, survival rate 93%. In this group two stent thrombosis underwent successful thrombolysis and endovascular repair of the underlying causative lesion, while three patients needed conversion to open repair.
CONCLUSIONS: The number of endovascular procedures is increasing in many countries and the results that have been reported are very different. In our opinion a randomized trial is necessary, and in the light of these results favorable for the open repair, also in patients considered to be at high risk for surgery, we recommend not to change the practice of the center.