This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Nationwide study of the outcome of popliteal artery aneurysms treated surgically. BJS 2007; 94: 970-977.
Published: 22nd May 2007
Authors: H. Ravn, D. Bergqvist, M. Björck
Background
The aim was to study the epidemiology and outcomes of popliteal artery aneurysm (PA) treated surgically.
Method
Among 110 000 procedures registered prospectively in the Swedish Vascular Registry (Swedvasc), there were 717 primary operations for PA among 571 patients. Patient records were reviewed and data validated against other registries.
Results
The median age of the patients was 71 years; 5·8 per cent were women. Among 264 legs treated urgently, 235 had acute ischemia and 24 had rupture. Of patients with unilateral PA, 28·1 per cent had an aortic aneurysm, 8·4 per cent an iliac aneurysm and 9·4 per cent a femoral aneurysm. Extra‐popliteal aneurysms were more common when the PAs were bilateral (P = 0·004). The rate of limb loss within 1 year of operation was 8·8 per cent; 12·0 per cent for symptomatic and 1·8 per cent for asymptomatic limbs (P < 0·001). Risk factors for amputation were symptomatic disease, poor run‐off, urgent treatment, age over 70 years, prosthetic graft and no preoperative thrombolysis when the ischaemia was acute. Amputation rates decreased over time (P = 0·003). Crude survival was 91·4 per cent at 1 year and 70·0 per cent at 5 years.
Conclusion
Multiple aneurysm disease was common when PAs were bilateral. Preoperative thrombolysis of acute thrombosis and the use of vein grafts for bypass improved outcome. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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