Open repair of asymptomatic popliteal artery aneurysm is associated with better outcomes than endovascular repair

Objective Open (OPAR) and endovascular (EPAR) repair are both used to treat popliteal artery aneurysm (PAA). We assessed outcomes of both modalities in the treatment of asymptomatic PAAs. Methods Vascular Quality Initiative (VQI) databases (2010 to 2013) were queried for patients undergoing asymptomatic PAA repair using OPAR and EPAR. The groups were compared with respect to demographics, medical history, and procedural characteristics. Outcomes of interest were length of stay (LOS), major adverse limb events (MALE), MALE or perioperative death (MALE-POD), and loss of primary patency compared using Kaplan-Meier estimates. Proportional hazard Cox regression was used to compare the outcomes across the treatment groups. Multivariable regression with backward elimination procedure (α = .5) was used to construct parsimonious models to predict MALE and MALE-POD. Gamma regression was used to compare LOS. Results From 2010 to 2013, 390 patients with asymptomatic PAAs were identified (221 OPAR, 169 EPAR) and included in this study. Preoperative comorbidities were similar between the two groups, except for a higher rate of congestive heart failure (19.5% vs 11.8%, P = .042) and chronic obstructive pulmonary disease (19.5% vs 11.8%, P = .042) in the EPAR group. No in-hospital mortality was observed. LOS was significantly longer in the OPAR group (3.8 ± 2.5 vs 1.4 ± 1.9 days; P < .001). OPAR patients had a significantly higher MALE-free survival (95% vs 80%; P