{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T21:56:52Z","timestamp":1791410212119,"version":"4.3.3"},"reference-count":13,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives:\u00a0Despite their low incidence, popliteal artery aneurysms (PAAs) are the most common aneurysms of the peripheral arteries and carry a high risk of limb loss. The optimal treatment, either with open (OR) or endovascular repair (ER), remains debated due to the lack of high-level evidence. Methods: In accordance with STROBE guidelines, we conducted a retrospective observational study with a prospective follow-up. All patients presenting with a PAA who underwent elective OR in the Vascular and Endovascular Surgery Unit of Agostino Gemelli Hospital (Rome, Italy) over the last four years were enrollved. Urgent and endovascular cases were excluded. Clinical examination, Doppler ultrasound (DUS), and contrast-enhanced computed tomography angiography (CTA) were performed preoperatively. Clinical and DUS follow-up was performed at 1, 3, 6, and 12 months postoperatively and annually thereafter. Endpoints were the primary, primary assisted, and secondary patency calculated using a Kaplan\u2013Maier estimate based on the \u201cfirst event\u201d (arterial stenosis, occlusion, or reintervention) after the procedure. Amputation rate and overall mortality were also assessed. The results were compared with the success and complication rates reported in contemporary endovascular series. Results: Overall, 62 open interventions for popliteal artery aneurysms were performed during the study period; 49 patients (100% male, 70.3 SD \u00b1 8.8 years) were included for a total of 52 PAAs treated electively (median diameter 30.5 mm, range 20\u201375; 92.3% fusiform). Aneurysm involved P1 segment in 38.5% of cases (20), P2 in 48.1% of cases (25), and P3 in 13.5% of cases (7). Two runoff vessels were present in most patients (37, 71.2%). Surgery consisted of the aneurysm\u2019s exclusion through ligation and autologous vein or prosthetic bypass (25, 48.1%) or aneurysmectomy and interposition graft or end-to-end anastomosis (27, 51.9%). At a mean follow-up of 18 months (SD \u00b1 17.7), the primary, the primary assisted, and the secondary patency were 94.3%, 100%, and 100% respectively. No minor nor major amputations and no deaths were reported. Conclusions: In the endovascular era, our results highlight that regardless the specific characteristics\u2014including age, comorbidities, and aneurysm anatomy\u2014OR provides excellent early and mid-term outcomes with high patency and low complication rate compared with contemporary endovascular series reported in the literature.<\/jats:p>","DOI":"10.3390\/diagnostics15202608","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T12:17:02Z","timestamp":1760617022000},"page":"2608","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Surgical Repair of Popliteal Artery Aneurysms Still Represent the Gold Standard: A Contemporary Cohort Study from a High-Volume Centre and Comparison with Contemporary Endovascular Series"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2422-5517","authenticated-orcid":false,"given":"Ottavia","family":"Borghese","sequence":"first","affiliation":[{"name":"Unit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S, 00168 Rome, Italy"},{"name":"Department of Cardiovascular Sciences, Vascular and Endovascular Surgery School, Faculty of Medicine and Surgery, Catholic University \u201cSacro Cuore\u201d, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9002-3031","authenticated-orcid":false,"given":"Teresa","family":"Lodico","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S, 00168 Rome, Italy"},{"name":"Department of Cardiovascular Sciences, Vascular and Endovascular Surgery School, Faculty of Medicine and Surgery, Catholic University \u201cSacro Cuore\u201d, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Cuozzo","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S, 00168 Rome, Italy"},{"name":"Department of Cardiovascular Sciences, Vascular and Endovascular Surgery School, Faculty of Medicine and Surgery, Catholic University \u201cSacro Cuore\u201d, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7304-7553","authenticated-orcid":false,"given":"Yamume","family":"Tshomba","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S, 00168 Rome, Italy"},{"name":"Department of Cardiovascular Sciences, Vascular and Endovascular Surgery School, Faculty of Medicine and Surgery, Catholic University \u201cSacro Cuore\u201d, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"121S","DOI":"10.1016\/j.jvs.2021.05.023","article-title":"A systematic review and meta-analysis of treatment and natural history of popliteal artery aneurysms","volume":"75","author":"Beuschel","year":"2022","journal-title":"J. Vasc. Surgery"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.jvs.2021.07.243","article-title":"Natural history, growth rates, and treatment of popliteal artery aneurysms","volume":"75","author":"Jergovic","year":"2022","journal-title":"J. Vasc. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"109S","DOI":"10.1016\/j.jvs.2021.04.040","article-title":"The Society for Vascular Surgery clinical practice guidelines on popliteal artery aneurysms","volume":"75","author":"Farber","year":"2022","journal-title":"J. Vasc. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1583\/08-2412.1","article-title":"Endovascular Exclusion of Popliteal Artery Aneurysms With Stent-Grafts: A Prospective Single-Center Experience","volume":"16","author":"Idelchik","year":"2009","journal-title":"J. Endovasc. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.jvs.2016.09.029","article-title":"Meta-analysis of open and endovascular repair of popliteal artery aneurysms","volume":"65","author":"Leake","year":"2017","journal-title":"J. Vasc. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.ejvs.2015.03.026","article-title":"Treatment of Popliteal Aneurysm by Open and Endovascular Surgery: A Contemporary Study of 592 Procedures in Sweden","volume":"50","author":"Cervin","year":"2015","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_7","first-page":"CD010149","article-title":"Endovascular versus open repair of asymptomatic popliteal artery aneurysm","volume":"12","author":"Joshi","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.avsg.2025.03.023","article-title":"Open Versus Endovascular Repair of Patent Popliteal Artery Aneurysms in an Elective Setting: A Multicenter Retrospective Study with Long-Term Follow-Up","volume":"117","author":"Ripepi","year":"2025","journal-title":"Ann. Vasc. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.jvs.2014.09.069","article-title":"Open repair of asymptomatic popliteal artery aneurysm is associated with better outcomes than endovascular repair","volume":"61","author":"Eslami","year":"2015","journal-title":"J. Vasc. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.ejvs.2024.09.038","article-title":"Re: Enhancing the Reliability of Popliteal Artery Aneurysm Treatment Outcomes: A Critical Review of the PARADE Study","volume":"69","author":"Troisi","year":"2025","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_11","first-page":"845","article-title":"Great saphenous vein versus expanded polytetrafluoroethylene graft in patients undergoing elective treatment of popliteal artery aneurysm with a posterior approach","volume":"82","author":"Troisi","year":"2025","journal-title":"J. Vasc. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.ejvs.2024.08.011","article-title":"Elective Surgical Repair of Popliteal Artery Aneurysms with Posterior Approach vs. Endovascular Exclusion: Early and Long Term Outcomes of Multicentre PARADE Study","volume":"69","author":"Troisi","year":"2025","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.ejvs.2025.04.041","article-title":"Long Term Follow Up after Endovascular Popliteal Artery Aneurysm Repair: A Two Centre, Retrospective Cohort Study (1998\u20132023)","volume":"70","author":"Baggel","year":"2025","journal-title":"Eur. J. Vasc. Endovasc. Surg."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/20\/2608\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T13:05:15Z","timestamp":1760619915000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/20\/2608"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,16]]},"references-count":13,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["diagnostics15202608"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15202608","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,16]]}}}