Retrospective analysis of the clinical outcomes following popliteal artery aneurysm repair

Introduction: Popliteal artery aneurysms (PAA) have a low incidence (0.1%–2.8%) in the general population. The aim of this study was to assess the outcomes of popliteal aneurysm repair with respect to the type of presentation, size of the aneurysm, mural thrombus, and the number of run-off vessels.
Methodology: This is a retrospective study carried out in the Royal Preston Hospital, United Kingdom from January 2015 to January 2021. All for those patients who were intervened for PAA were included except  who were managed conservatively.
Results: A total of 42 patients were treated for PAA during this study period. All the patients were male and the mean age at presentation was 75.2 years (±9 years). The mean diameters of symptomatic and asymptomatic patients with PAA were 4.11 cm (± 1.74 cm) and 3.3cm (±0.79 cm) respectively (p=0.08). Considering the presence of a mural thrombus, 44% (n=7) of asymptomatic patients presented with a mural thrombus, and in symptomatic patients, 50% had symptoms of acute limb ischemia. Regarding management, all of the asymptomatic patients had undergone bypass surgery. Considering symptomatic patients, the majority (88%) had undergone bypass surgery, and only three patients had undergone endovascular stenting. In the 30-day follow-up, 5% (n=2) of the patients had undergone below knee amputation, both of them presented with mural thrombosis and had single run-off vessels (p=0.03). Stent occlusion occurred in one case in 30 days.
Conclusion: In our experience, symptomatic clinical presentation and poor run-off vessels were significantly associated with poor outcomes.