LAUSR

OBJECTIVES Popliteal artery aneurysms (PAA) are the most common peripheral aneurysms. Although rare and often asymptomatic there is a significant risk of thrombosis, embolism and limb loss. The aim of this study was to evaluate the eligibility for endovascular repair of patients treated for symptomatic and asymptomatic PAA according to the instructions for use (IFU). MATERIAL AND METHODS All patients treated for PAA with open surgical repair between the years 2010 - 2017 were analysed if suitable for endovascular treatment. Preoperative imaging was reviewed for applicability with an interventional radiologist and two vascular surgeons. Evaluation was performed according to the following criteria adapted from the IFU of Gore ® Viabahn stent graft: at least a single vessel tibial run-off, proximal and distal landing zone more than 2 cm, no large difference in vessel diameter proximal and distal to the aneurysm, no overstenting of significant collaterals necessary and no inadequate kinking of the artery. The patients were classified in three categories: the patient was eligible, endovascular treatment was feasible and endovascular treatment was not appropriate. RESULTS 51 patients with 61 symptomatic and asymptomatic PAA were identified. 45 cases were asymptomatic, 11 cases showed clinical symptoms such as claudication and in 5 cases the patients presented with acute ischemia. Endovascular intervention was eligible in 24 patients, 14 cases were feasible and in 23 cases was not appropriate according the IFU. CONCLUSION In this study more than one third of the patients with PAA were not eligible for endovascular treatment according to the IFU and another 23 % showed substantial reasons against endovascular treatment. This data suggests that endovascular repair remains a treatment option for selected patients only. Cross-sectional imaging is mandatory for procedure selection.