OBJECTIVES: A popliteal artery aneurysm (PAA) is a bulging and weakness in the popliteal artery vessel wall. Treatment options include an endovascular repair (ER) using the GORE^® VIABAHN^® Endoprosthesis with PROPATEN Bioactive Surface and open surgical repair with autogenous conduit (OSR). Data reported in the national hospital dataset for ER and OSR were compared.

METHODS: Data was extracted from the InEK DatenBrowser¹ for 2021 using ICD code I72.4 Aneurysm and dissection of artery of lower extremity for the primary diagnosis, procedure codes 8.83b.e1 for the ER cohort, 5.393.53-55 and 5.930.00-.01 for the OSR cohort. Age, hospital stay duration, secondary diagnoses and DRG category were compared.

RESULTS: There were 5,043 PAA cases reported for 2021, of these 1,471 (29.2%) were OSR and 391 (7.7%) were ER. Compared to OSR, the ER cohort had a higher proportion of patients aged over 65 years (76.5% versus 64.0%). The hospital stay was considerably lower for ER at 6.3 days versus 12.8 days.

For secondary diagnoses, the ER cohort had fewer cases of ICD code I74.3 embolism and thrombosis of lower extremity arteries (12.8% versus 24.0%), T81.0 haemorrhage and hematoma as complication of surgery (10.8% versus 16.3%) and D62 acute post-haemorrhage anaemia (7.4% versus 19.8%).

The weighted average DRG rate per case reported was 5,503€ for ER (excluding NUB payment) and 11,395€ for OSR. In the ER cohort 86% of cases were reimbursed within DRG F59 D-B (4,712€ –7,660€) and 94% of OSR cases were reimbursed within DRG F08 E-B (7,940€ – 21,260€).

CONCLUSIONS: Hospital case data demonstrated that PAA repair with the GORE^® VIABAHN^® Device was used more frequently in older patients and required shorter hospital stay. It had fewer cases with secondary diagnoses of thrombosis, haemorrhage and hematoma. The cost to the health care payer was lower reflected in a smaller average DRG value.