External stenting and disease progression in vein grafts 1 year after open surgical repair of popliteal artery aneurysm

J Vasc Surg. 2021 Aug;74(2):521-527. doi: 10.1016/j.jvs.2021.01.046. Epub 2021 Feb 14.

Abstract

Objective: Open surgical repair remains the gold standard treatment for popliteal artery aneurysms (PAA). The objective of this study was to evaluate the safety of external stenting and its medium-term effect on vein graft disease after open PAA repair.

Methods: Between December 2017 and September 2019, 12 consecutive patients with PAA underwent open surgical repair with externally stented saphenous vein grafts. Duplex ultrasound scanning of the grafts was performed at discharge and at 3, 6, and 12 months after the procedure to evaluate graft patency, average lumen diameter and lumen uniformity.

Results: Eleven patients underwent aneurysm ligation and bypass grafting and one patient was treated with aneurysm exclusion and interposition of a venous segment. External stenting of the vein graft was successful in all patients. The mean follow-up time was 12 months (range, 7-17 months), with a primary patency rate of 100% and no graft revisions or reinterventions. The mean lumen diameters at 3, 6, and 12 months were 5.9 ± 1.2 mm, 5.7 ± 0.8 mm, and 5.7 ± 0.7 mm, respectively, with no significant changes between 3 and 6 (P = .34) and between 6 and 12 months (P = .34). The coefficient of variance at 3, 6, and 12 months was 8.2 ± 9.3, 9.4 ± 7.2, and 10.4 ± 8.9, respectively, with no significant change between 3 and 6 months (P = .78) or 6 and 12 months (P = .98). No mortality or amputations were recorded throughout the follow-up period.

Conclusions: External stenting of vein grafts in open surgical repair of PAA is feasible and safe. This technique may potentially improve the outcomes of surgical repair in patients with PAA.

Keywords: External stenting; Graft patency; Popliteal aneurysm open repair; Vein graft aneurysmal degeneration; Vein graft failure.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aneurysm / diagnostic imaging
  • Aneurysm / surgery*
  • Chromium Alloys
  • Computed Tomography Angiography
  • Disease Progression
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Female
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / physiopathology
  • Graft Occlusion, Vascular / prevention & control*
  • Humans
  • Male
  • Middle Aged
  • Popliteal Artery / diagnostic imaging
  • Popliteal Artery / surgery*
  • Prosthesis Design
  • Retrospective Studies
  • Saphenous Vein / diagnostic imaging
  • Saphenous Vein / physiopathology
  • Saphenous Vein / transplantation*
  • Stents*
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex
  • Vascular Patency

Substances

  • Chromium Alloys