liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
Treatment of Popliteal Aneurysm by Open and Endovascular Surgery: A Contemporary Study of 592 Procedures in Sweden
Uppsala University, Sweden; NU Hospital Org, Sweden.
Uppsala University, Sweden; NU Hospital Org, Sweden.
Uppsala University, Sweden; Lillebaelt Hospital, Denmark.
Malmö University Hospital, Sweden.
Show others and affiliations
2015 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 50, no 3, 342-350 p.Article in journal (Refereed) Published
Abstract [en]

WHAT THIS STUDY ADDS Previous comparisons between open and endovascular repair of popliteal aneurysms have focused on asymptomatic patients, and have short follow up. This study is strengthened by the fact that it is contemporary, population based, without any selection bias, reporting on all kinds of presentations, and has approximately 90% 1 year follow up data. It shows that endovascular repair has significantly inferior results compared with open repair, in particular in the group of patients who present with acute ischaemia. We believe these results will make many vascular surgeons think twice before they treat patients endovascularly in the future. Background: Popliteal aneurysm (PA) is traditionally treated by open repair (OR). Endovascular repair (ER) has become more common. The aim was to describe time trends and compare results (OR/ER). Methods: The Swedish vascular registry, Swedvasc, has a specific PA module. Data were collected (2008-2012) and supplemented with a specific protocol (response rate 99.1%). Data were compared with previously published data (1994-2002) from the same database. Results: The number of operations for PA was 15.7/million person-years (8.3 during 1994-2001). Of 592 interventions for PA (499 patients), 174 (29.4%) were treated for acute ischaemia, 13 (2.2%) for rupture, 105 (17.7%) for other symptoms, and 300 (50.7%) were asymptomatic (31.5% were treated for acute ischaemia, 1994-2002, p = .58). There were no differences in background characteristics between OR and ER in the acute ischaennia group. The symptomatic and asymptomatic groups treated with ER were older (p = .006, p less than .001). ER increased 3.6 fold (4.7% 1994-2002, 16.7% 2008-2012, p = .0001). Of those treated for acute ischaemia, a stent graft was used in 27 (16.4%). Secondary patency after ER was 70.4% at 30 days and 47.6% at 1 year, versus 93.1% and 86.8% after OR (p = .001, less than .001). The amputation rate at 30 days was 14.8% after ER, 3.7% after OR (p = .022), and 17.4% and 6.8% at 1 year (p = .098). A stent graft was used in 18.3% for asymptomatic PA. Secondary patency after ER was 94.5% at 30 days and 83.7% at 1 year, compared with 98.8% and 93.5% after OR (p = .043 and 0.026). OR was performed with vein graft in 87.6% (395/451), with better primary and secondary patency at 1 year than prosthetic grafts (p = .002 and less than .001), and with a posterior approach in 20.8% (121/581). Conclusions: The number of operations for PA doubled while the indications remained similar. ER patency was inferior to OR, especially after treatment for acute ischaemia, and the amputation risk tended to be higher, despite similar pre-operative characteristics. (C) 2015 The Authors. Published by Elsevier Ltd on behalf of European Society for Vascular Surgery. This is an open access article under the CC BY-NC-SA license (

Place, publisher, year, edition, pages
W B SAUNDERS CO LTD , 2015. Vol. 50, no 3, 342-350 p.
Keyword [en]
Popliteal artery aneurysm; Open repair; Endovascular; Stent graft; Registry; Amputation
National Category
URN: urn:nbn:se:liu:diva-122118DOI: 10.1016/j.ejvs.2015.03.026ISI: 000361576800016PubMedID: 25911500OAI: diva2:861775

Funding Agencies|Swedish Research Council [K2013-64X-20406-07-3]

Available from: 2015-10-19 Created: 2015-10-19 Last updated: 2016-01-07

Open Access in DiVA

fulltext(611 kB)41 downloads
File information
File name FULLTEXT01.pdfFile size 611 kBChecksum SHA-512
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Welander, Martin
By organisation
Division of Cardiovascular MedicineFaculty of Medicine and Health Sciences
In the same journal
European Journal of Vascular and Endovascular Surgery

Search outside of DiVA

GoogleGoogle Scholar
Total: 41 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 81 hits
ReferencesLink to record
Permanent link

Direct link