Abstract:
Objective: To elucidate the outcomes of open surgery for popliteal artery
aneurysm (PAA) in a single Japanese institution. Materials and Methods:
Between 1999 and 2016, 35 patients (44 PAAs) underwent open surgery in our
department. The first-line surgical strategy involved the medial approach,
with excision of the aneurysm sac and autologous vein bypass grafting. Associations
between the outcomes and 1) the surgical management of the aneurysmal
sac (aneurysmectomy vs. ligation with bypass) and 2) the preoperative
clinical symptoms were evaluated. Results: There were no aneurysm-related
deaths during the follow-up period (mean, 4 years; range, 1 - 17.6 years). The
5-year primary, primary-assisted, and secondary patency rates were 67.9%,
72.7%, and 94.5%, respectively. Re-intervention was required for 19 PAAs (14
patients), including two PAAs in patients with suspected Behçet’s disease. Patency
rates did not differ between the aneurysmectomy and ligation groups.
Remnant sac enlargement occurred in 3 cases. Among asymptomatic patients,
clinical symptoms did not deteriorate; however, the ankle brachial pressure
index decreased ≥0.15 in patients with artery-graft mismatching. Conclusion:
Patency rates were good, and our modified ligation with bypass procedure,
which involves excising the sac as much as possible, exhibited less risk in
terms of remnant sac enlargement compared to that in previous studies
