Objective: To
elucidate the outcomes of open surgery for popliteal artery aneurysm (PAA) in a
single Japanese institution. Materials and Methods: Between 1999 and
2016, 35 patients (44 PAAs) underwent open surgery in our department. The
first-line surgical strategy involved the medial approach, with excision of the
aneurysm sac and autologous vein bypass grafting. Associations between the
outcomes and 1) the surgical management of the aneurysmal sac (aneurysmectomy
vs. ligation with bypass) and 2) the preoperative clinical symptoms were
evaluated. Results: There were no aneurysm-related deaths during the
follow-up period (mean, 4 years; range, 1 - 17.6 years). The 5-year primary,
primary-assisted, and secondary patency rates were 67.9%, 72.7%, and 94.5%,
respectively. Re-intervention was required for 19 PAAs (14 patients), including
two PAAs in patients with suspected Behçet’s disease. Patency rates did not
differ between the aneurysmectomy and ligation groups. Remnant sac enlargement
occurred in 3 cases. Among asymptomatic patients, clinical symptoms did not
deteriorate; however, the ankle brachial pressure index decreased ≥0.15 in
patients with artery-graft mismatching. Conclusion: Patency rates were
good, and our modified ligation with bypass procedure, which involves excising
the sac as much as possible, exhibited less risk in terms of remnant sac
enlargement compared to that in previous studies.
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