XXXX : diagnostic workup and results of surgical treatment.

@entity1 @entity449 @entity63 @entity4 @entity439 @entity1410 @entity158 @entity736 @entity291
@entity439 (PA) may cause serious complications. Early detection and surgery are beneficial. What are the circumstances under which the diagnosis of PA is made? What risks are associated with the treatment? A total of 36 consecutive PAs in 22 @entity1 and 2 @entity1 were treated in a single-center series. Altogether, 26 surgical reconstructions (group 1) were performed using a medial approach, and two PAs were resected through a dorsal approach. Eight @entity1 with eight PAs did not undergo surgery (group 2): Two were awaiting surgery, and six had refused it. At the time of diagnosis, 25 PAs were symptomatic: @entity158 , @entity4 , or "pulsation" in the popliteal groove (29%); claudication of the foot/ @entity291 (39%); critical @entity63 (21%). Eleven asymptomatic cases were discovered during screening duplex sonography of known @entity449 . Among the 28 PAs that underwent surgery, 6 produced acute symptoms. The following complications were observed: five postoperative @entity1410 , one infected @entity736 ( @entity736 ) graft, two early graft occlusions, and two significant stenoses of the distal anastomosis. After a mean follow-up of 15 months (range 2-43 months), group 1 had a limb salvage rate of 100% and a secondary patency rate of 96%. Two @entity1 are still awaiting surgery. Critical @entity63 represents an absolute indication for surgical repair, but the observed zero mortality and relatively low morbidity associated with the intervention combined with a favorable patency rate justify the liberal use of surgery even for asymptomatic PAs. The extensible medial approach is preferred. Sequential reconstruction is advised for bilateral PAs.
