Peripheral arterial aneurysms: open or endovascular surgery?

[thoracic outlet syndrome]

Peripheral arterial aneurysms are uncommon ; for some aneurysm types , data are limited to case reports and small case series . There is no Level A evidence in most cases to determine the choice between open or endovascular intervention . The evolution of endovascular technology has vastly improved the armamentarium available to the vascular surgeon and interventionalists in the management of these rare and unusual aneurysms . The choice of operative approach will ultimately be determined on an individual basis , dependent on the patient risk factors , and aneurysm anatomy . After consideration , some aneurysms (femoral , subclavian , carotid and ECAA ) fare better with an open first approach ; renal , splenic and some visceral artery aneurysms do better with an endovascular first approach . In our practice PAAs are treated with an endovascular first approach . For these rare conditions , both open and endovascular therapy will continue to work in harmony to enhance and extend the capabilities of modern surgical management .