Treatment of Asymptomatic Popliteal Artery Aneurysm ≥20 mm with Diminished Life Expectancy and High Cardiovascular Risk

This protocol addresses a specific clinical scenario: an asymptomatic popliteal artery aneurysm of 20 mm or more in diameter, occurring in a patient whose life expectancy is less than five years and who carries a high cardiovascular risk burden.

Clinical scenario

Asymptomatic popliteal artery aneurysm — diameter ≥20 mm
Diminished life expectancy (less than 5 years)
High cardiovascular risk

When intervention is indicated in this population, the patient's limited prognosis and elevated operative risk make the choice of approach critically important. An endovascular repair strategy is considered for eligible patients in this situation, favoured for reasons related to its physiological demands and postoperative profile. The complete protocol specifies the indications, technical criteria, and full management pathway.

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References

DOI: 10.1016/j.jvs.2021.04.040

For patients with a diminished life expectancy, if intervention is indicated, endovascular repair should be considered.

If treatment of a PAA is indicated for such patients, because endovascular treatment is less taxing and has fewer postoperative complications, EPAR should be considered, regardless of the availability of the GSV or quality of the runoff vessels.

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