This is a retrospective review from de Department of Vascular Surgery in West Virginia University of all patients with popliteal aneurysms treated at our institution from 2001 to 2011. Eighty-eight aneurysms (72 patients) were treated during this period. Indications for intervention included symptomatic presentations in 53%. Treatment included endovascular exclusion in 24, surgical repair in 63 and primary amputation in one patient. Nine aneurysms received catheter-directed thrombolysis. The mean length of stay was 3.9 days vs 9.5 days (P < .001), favoring endovascular treatment. There were no perioperative (30-day) deaths in the endovascular group and one in the surgical cohort. The mean patency follow-up was 21.2 vs 28.3 months. Primary patency did not differ between endovascular and surgically treated patients at 1 year (92.9% vs 83.3%; P [ .26) and 3 years (63.7% vs 77.8%; P [ .93). Endovascular patients had a midterm survival rate of 65% (mean follow-up, 33.9 months), whereas surgical patients experienced a survival rate of 80.8% (mean follow-up, 42.9 months; P [ .22). Conclusions: Endovascular treatment of popliteal aneurysms provides similar short-term patency to that of the traditional gold standard approach with surgical bypass, with shorter hospitalizations in both symptomatic and asymptomatic patients. Further long-term follow-up is required to compare these two treatment modalities for durability to determine the optimal popliteal aneurysm management. (J Vasc Surg 2013;57:1306-10.)
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