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PVSS15. The Medial Vs. The Posterior Approach In The Repair Of Popliteal Artery Aneurysms: A Multicenter Case-Matched Study

Rogier H. J. Kropman, Hjalmar C. van Santvoort, Joep Teijink, Henricus D. W. M. van de Pavoordt,  Henricus J. Belgers, Frans L. Moll, Jean-Paul P. M. de Vries.
St. Antonius Hospital, Nieuwegein, Intl, Netherlands.

OBJECTIVES: To compare early and mid-term results of medial (MA) and posterior (PA) surgical approach to treat popliteal artery aneurysms (PAAs).

METHODS: From 1992 to 2006 66 patients (mean age 72±10 years), underwent surgery for PAAs by either a PA or MA. Patients were case matched according to patient age, co-morbidity, indication for PAA repair, PAA diameter, PTFE or venous bypass.

RESULTS: In the 30-days post-operative period, 7 complications occurred in each group, no patients died, and no amputations were necessary. Mean follow-up (including duplex scanning) was 47 months (range, 2-176). The primary and secondary patency rates at 4 years in the PA were 66% and 90% and for the MA 69% and 90% (NS). Limb salvage rates were not significantly different (97% PA vs. 100% MA). In two patients of the MA (6%) PAA growth due to persistent flow in the aneurysm led to late conversion to a posterior approach.

CONCLUSIONS: In the absence of significant differences in complication rates and mid-term patency rates between the PA and MA, and considering the risk of aneurysm growth after medial approach, the posterior approach seems the surgical method of preference for PAA repair.