BACKGROUND: Management of asymptomatic @entity439 is controversial, and the prognosis for acutely thrombosed @entity439 is notoriously poor. We evaluated the management and outcome for @entity439 . @entity1 AND METHODS: A retrospective review of all @entity1 with @entity439 between 1988 and 2000 was carried out. Fifty-two limbs were operated on in 41 @entity1 . Data collected included findings at presentation, operative details, graft patency, limb salvage, complications, and 30-day mortality. RESULTS: Initial findings included @entity63 (n = 14), no symptoms (n = 29), acute @entity397 (n = 2), chronic @entity63 (n = 5), and symptoms of nerve or vein compressive (n = 2). All @entity1 with symptomatic @entity439 and 22 @entity1 with asymptomatic @entity439 (21 larger than 2 cm in diameter, 1 with @entity715 at duplex ultrasound scanning) underwent surgery as first-line treatment. Of the 7 @entity1 with asymptomatic @entity439 managed with surveillance with duplex ultrasound scanning, @entity63 developed in three, 1 @entity439 ruptured, compressive symptoms developed in 1, and 2 remained asymptomatic but required surgery because of @entity439 (>2 cm). Of the 17 @entity1 with @entity63 , 13 had neurologic signs and underwent immediate thromboembolectomy (trifurcation alone in 8, ankle-level arteriotomy in 4) and bypass grafting (n = 12) or inlay grafting (n = 1), and the other 4 underwent intra-arterial thrombolysis initially. Of these 4 procedures, 2 were successful and had elective surgery; the other 2 required urgent surgery because of @entity887 and failure of recanalization. Thirteen of the 17 grafts were to the crural vessels. Bypass grafting (medial approach) was used in 16 of the 17 @entity1 with @entity63 , all 5 @entity1 with chronic @entity63 , and the 8 @entity1 with no symptoms. An inlay technique (posterior approach) was used in 16 @entity1 with no symptoms, the 3 @entity1 with symptoms of nerve or vein compression, and 1 @entity1 with @entity63 . The distal anastomoses were to the below-knee popliteal artery in 35 @entity1 and the crural arteries in 15 @entity1 , using autologous vein. Two of the @entity1 with @entity397 underwent ligation alone, the other undergoing bypass grafting in addition. The overall 5-year primary patency rate was 69%, secondary patency rate was 87%, and limb salvage rate was 87%. Limb salvage was achieved in 14 of the 17 @entity1 with @entity63 . @entity1 with asymptomatic @entity439 had better secondary graft patency (100%) compared with symptomatic @entity439 (74%; P <.01). Acute @entity63 , technique used, and crural artery grafts were not predictors of graft failure with either univariate or multivariate analysis. Symptomatic @entity439 were associated with more @entity260 and greater 30-day mortality (4 of 28 vs 0 of 24). CONCLUSION: Thromboembolectomy followed by crural bypass grafting is an effective treatment for @entity439 with severe @entity63 . Outcome is better with surgical management of asymptomatic @entity439 compared with symptomatic @entity439 .

Surgery of popliteal artery XXXX : a 12-year experience.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'PATIENTS'] @entity63 :: ('MESH:D007511', 'Disease') :: ['acute ischemia', 'acute limb ischemia', 'ischemia'] @entity260 :: ('MESH:D011183', 'Disease') :: ['postoperative complications'] @entity887 :: ('MESH:D004617', 'Disease') :: ['secondary distal embolism'] @entity439 :: ('MESH:D000783', 'Disease') :: ['popliteal aneurysm', 'aneurysms', 'aneurysm', 'aneurysm enlargement'] @entity397 :: ('MESH:D012421', 'Disease') :: ['rupture'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thrombus']
@entity439 :: (MESH:D000783,Disease) :: ['aneurysms']
