Popliteal Aneurysms, Tailored Management Options; Single-Center Experience.

Background: This study aims to review contemporary lines of management of popliteal artery aneurysm (PAAs) illustrating the pros and cons of each treatment modality. Methods: This is a prospective cohort study of all consecutive PAAs treated between 2015-2017. All patients Patients' data were entered into a prospectively designed registry including all clinical, radiologic, operative and postoperative data. Results: The study included thirty-seven PAAs in 35 patients. Management was by open repair in 48.6%, while endovascular repair in 24.3%, primary major amputation in 5.4%, and surveillance in 21.6%. PAAs were asymptomatic in 32.4% and symptomatic in 67.6% (acute ischemia in 35.1%, claudication in 32.4%, rupture in 8.1% and leg swelling and pain in 8.1%). An emergency procedure done in 29.7%, elective procedure in 51.4% and no intervention in 18.9%. Length of hospital stay in open repair was 15.1 days and in endovascular repair was 2 days. One year patency, limb salvage and mortality rates were 53.3%, 60% and 26.7%, respectively in open repair and were 75%. 100%, and .0%, respectively in endovascular repair (p=0.526). Conclusions: Results of repair of asymptomatic PAAs are significantly better than those in symptomatic PAAs. In the emergency setting with severe limb ischemia and complete thrombosis of PAAs, there is significantly increased mortality, limb loss, and decreased primary patency rate. Endovascular treatment is feasible in selected patients with having adequate landing zones. A prospective randomized trial is necessary to compare the immediate and long-term outcome of endovascular repair with open repair in a large population of patients with PAAs. [ABSTRACT FROM AUTHOR]