According to the results of a eight-year study presented by Dr Eric L G Verhoeven, Associate Professor and Consultant Vascular Surgeon at the University Medical Center Groningen (The Netherlands), endovascular treatment for popliteal aneurysm disease were found it to be an effective, simple procedure from which patients generally make a quick and long-lasting recovery. The results were eagerly awaited as there are relatively few studies analysing long-term safety and effectiveness of endovascular treatment.
The study included 72 cases in which endografts were placed in patients with popliteal aneurysm disease who were found to have suitable anatomy for the procedure. All 72 procedures were technically successful. During follow-up, 16 (22%) stent-grafts occluded; ten needed treatment for this occlusion, but five re-occluded. Another eight re-interventions other than for occlusion were required, but half of these can directly be accounted for to the initial learning curve.
Only one patient required open surgery and no patients underwent amputation. The group also found that treating postoperative patients with clopidogrel added to aspirin during the first eight weeks of recovery resulted in better patency (lack of blockage). Five years into the study, the primary patency was 70%, with a secondary patency of 79%, which is considered an acceptable rate. Verhoeven expects these rates to improve with the use of better anticoagulation therapy, such as a six-month course of clopidogrel, as well as from refinements to the technical execution of the procedure.
Based on these study findings and their extensive experience, Verhoeven still considers open surgery a first option for good-risk patients. “However, for all other patients, especially those who lack good veins for bypass surgery, endografts have proven to be a safe and effective treatment. With this study in hand, endovascular repair can be regarded a valid option for treatment of popliteal aneurysm,” he added.