Objective: During the last decade, endovascular repair of popliteal artery aneurysms (PAAs) has become a valid alternative to open repair. This study analyzes the incidence and origin of stein graft fractures after endovascular repair, its impact on patency, and strategies to prevent fractures.
Methods: Data of 78 atherosclerotic PAAs in 64 patients were gathered in a prospectively-held database from 1998 to 2009. All x-rays were reviewed to detect stent fractures. Only circumferential fractures were included for analysis; localized strut fractures were excluded. Clinical endpoints were circumferential stein fracture, occlusion, and clinical status of the patient.
Results: Mean follow-up time was 50 months (range, 1-127 months). Fifteen circumferential stein fractures occurred in 13 (16.7%) patients. The majority of stein fractures (93.3%) were associated with the use of multiple stein grafts. At univariate analysis, younger age was identified as the only significant predictor for stein fracture (P = .007). The cumulative stein fracture-free survival was estimated at 78% and 73% at 5- and 10-year follow-up, respectively. The cumulative primary patency rate, defined as time to occlusion, was not different for the fracture group compared with the nonfracture group (P = .284).
Conclusions: The incidence of stent fractures after endovascular PAA repair is probably underreported in the literature. Stent graft fractures mainly occur at overlap zones and are associated with younger age of the patient. Fracture of the stern did not significantly influence patency of the stein graft. (J Vase Surg 2010;51:1413-8.)