Popliteal artery aneurysm - What is the best mode of treatment? Review of the literature and call for a register study,Poplitealarterienaneurysma - Was ist die beste behandlungsoption? Literaturübersicht und aufruf zu einer registerstudie

Evidence-based statements on the question whether popliteal artery aneurysms (PAA) should be treated by endovascular means or by open surgery are lacking. Overall, there are no major safety concerns regarding endovascular treatment which has resulted in some European countries establishing databases to document the results of treatment of PAA. The present paper explains why Germany should also undertake such a registry. The alternative of a prospective randomized trial, as initiated for asymptomatic patients under the clinical trials number NCT01817660 in the USA is also discussed. Due to the expected long recruitment period in view of the low prevalence of the disease, this alternative is not a realistic option in Germany. In addition, numerous exclusion criteria and the inherent stratification of a randomized trial would lower the relevance of such a study. Therefore, it would be more appropriate to register the nationwide results of all forms of PAA (i.e. symptomatic, asymptomatic and thrombosis as an emergency indication) and to evaluate the amputation rates. The concept of a nationwide German registry is presented.