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ABSTRACT
Background. Popliteal artery aneurysm (PAAs) is the most common periphereal artery aneurysm, but thromboembolic complications may result in limb loss. The aim of this study was evaluate the management and early outcomes for popliteal aneurysm. Patients and methods. A retrospective review of all patients with popliteal aneurysm between 2016 and 2020. Data collected included findings at presentation, operative details, graft patency, complications, and 30-day mortality.
Results. Twenty-seven limbs were operated on in 25 patients, consisting of 21 (84%) men and 4 (16%) women. Initial findings included 21 (84%) unilateral and 4 (16%) bilateral PAAs with a mean diameter of 35 ± 9 mm. Nine symptomatic patients with, thrombosis (n=4), intermittent claudication (n=2), critical ischemia (n=2), and local pain (n=1). Medial approach was realized in 20 (80%) patients. Proximal and distal ligation with bypass grafting was used in seventh (68%) patients, aneurysmectomy with interposition in eight (32%). Great saphenous vein was used in all cases. The 30-day postoperative mortality was 0%, and two amputations were necessary after failed bypass grafting in emergency patients. Two compartment syndrome, and one deep wound infection were reported. The perioperative 30-day primary patency rate was 86.6%, and secondary patency rate at 6 months was 100%. Conclusion. Results of management of popliteal arterial aneurysm on asymptomatic patients seem better than in emergency cases. Medial approach remains one of the best option for surgical treatment.

RÉSUMÉ
Introduction. Les anévrismes de l’artère poplitée sont les plus fréquents des anévrismes périphériques, et leurs complications thromboemboliques peuvent entrainer une amputation. L’objectif de cette étude est d’évaluer le traitement chirurgical et les suites opératoires. Patients et methods.  Il s’agit d’une étude retrospective, incluant tous les patients opérés pour anévrisme de l’artère poplitée entre Juin 2016 et Juin 2020. Les données collectées incluaient ; la clinique, le périopératoire, et la mortalité hospitalière. Résultats.  Vingt-sept anévrismes de l’artère poplitée ont été opérés parmi 25 patients, 21 (84%) hommes et 4 (16%) femmes. On notait 21 (84%) unilateral and 4 (16%) bilateral anévrismes poplités, avec un diamètre moyen de 35 ± 9 mm. Neuf patients étaient symptomatiques avec, thrombose (n=4), claudication intermittente (n=2), ischémie aigué (n=2), douleurs (n=1). L’abord médial a été réalisé chez 20 (80%) patients. Ligature proximale et distale associée à une pontage a représenté dans 68%, et la mise à plat plus greffe dans 32%. La veine grande a été le principal greffon utilisé. La mortalité hospitalière était nulle ; amputations ont été réalisées après occlusion du greffon chez deux patients opérés en urgence. Deux cas de syndrome de loges ont été rapportés ; avec une infection du site d’anastomose. La perméabilité primaire des trente premiers jours était de 86.6%, et la perméabilité secondaire à 6 mois était de 100%. Conclusion. Les résultats de la chirurgie des anévrismes de l’artère poplitée chez les patients asymptomatiques par rapport aux urgences. L’abord médial reste une des meilleures options de la chirurgie.

Keywords

Popliteal artery aneurysm surgery.

Article Details

How to Cite
Atipo-galloye, R., Edzan, J., Moumpala, S., Tseyi Ossere, B., & Sayah, R. (2021). Is Medial Approach for Surgical Treatment of Popliteal Artery Aneurysm Still Safe ?. HEALTH SCIENCES AND DISEASE, 22(3). https://doi.org/10.5281/hsd.v22i3.2607
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