Grip, OMani, KAltreuther, MBastos Gonçalves, FBeiles, BCassar, KDavidovic, LEldrup, NLattmann, TLaxdal, EMenyhei, GSetacci, CSettembre, NThomson, IVenermo, MBjörck, M2024-01-192024-01-192020Eur J Vasc Endovasc Surg . 2020 Nov;60(5):721-729.http://hdl.handle.net/10400.17/4794Objective: Popliteal artery aneurysm (PAA) is the second most common arterial aneurysm. Vascunet is an international collaboration of vascular registries. The aim was to study treatment and outcomes. Methods: This was a retrospective analysis of prospectively registered population based data. Fourteen countries contributed data (Australia, Denmark, Finland, France, Hungary, Iceland, Italy, Malta, New Zealand, Norway, Portugal, Serbia, Sweden, and Switzerland). Results: During 2012-2018, data from 10 764 PAA repairs were included. Mean values with between countries ranges in parenthesis are given. The incidence was 10.4 cases/million inhabitants/year (2.4-19.3). The mean age was 71.3 years (66.8-75.3). Most patients, 93.3%, were men and 40.0% were active smokers. The operations were elective in 73.2% (60.0%-85.7%). The mean pre-operative PAA diameter was 32.1 mm (27.3-38.3 mm). Open surgery dominated in both elective (79.5%) and acute (83.2%) cases. A medial surgical approach was used in 77.7%, and posterior in 22.3%. Vein grafts were used in 63.8%. Of the emergency procedures, 91% (n = 2 169, 20.2% of all) were for acute thrombosis and 9% for rupture (n = 236, 2.2% of all). Thrombosis patients had larger aneurysms, mean diameter 35.5 mm, and 46.3% were active smokers. Early amputation and death were higher after acute presentation than after elective surgery (5.0% vs. 0.7%; 1.9% vs. 0.5%). This pattern remained one year after surgery (8.5% vs. 1.0%; 6.1% vs. 1.4%). Elective open compared with endovascular surgery had similar one year amputation rates (1.2% vs. 0.2%; p = .095) but superior patency (84.0% vs. 78.4%; p = .005). Veins had higher patency and lower amputation rates, at one year compared with synthetic grafts (86.8% vs. 72.3%; 1.8% vs. 5.2%; both p < .001). The posterior open approach had a lower amputation rate (0.0% vs. 1.6%, p = .009) than the medial approach. Conclusion: Patients presenting with acute ischaemia had high risk of amputation. The frequent use of endovascular repair and prosthetic grafts should be reconsidered based on these results.engHSM CIR VASCHumansAgedMaleFemaleMiddle AgedAcute Disease / epidemiologyAcute Disease / therapyAmputation, Surgical / statistics & numerical dataAneurysm / complicationsAneurysm / epidemiologyAneurysm / pathologyAneurysm / surgery*Australia / epidemiologyBrazil / epidemiologyElective Surgical Procedures / adverse effectsElective Surgical Procedures / methodsElective Surgical Procedures / statistics & numerical dataEndovascular Procedures / adverse effectsEndovascular Procedures / methodsEurope / epidemiologyIncidenceGlobal Burden of DiseaseIschemia / epidemiologyIschemia / etiologyIschemia / surgery*Limb Salvage / adverse effectsLimb Salvage / methodsLimb Salvage / statistics & numerical data*New Zealand / epidemiologyPopliteal Artery / pathology*Popliteal Artery / surgeryProspective StudiesRisk FactorsRegistries / statistics & numerical dataRetrospective StudiesThrombosis / epidemiologyThrombosis / etiologyThrombosis / surgery*Treatment OutcomeVascular Grafting / adverse effectsVascular Grafting / methodsVascular Grafting / statistics & numerical dataVascular Patencyjournal article10.1016/j.ejvs.2020.07.005