Comparison of posterior and medial approaches for popliteal artery aneurysms

Mazzaccaro, Daniela; Carmo, Michele; Dallatana, Raffaello; Settembrini, Alberto M.; Barbetta, Iacopo; Tassinari, Luca; Roveri, Sergio; Settembrini, Piergiorgio

doi:10.1016/j.jvs.2015.06.227

Cited by 29 publications

(27 citation statements)

References 18 publications

(16 reference statements)

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“…Existen dos vías de abordaje en cirugía abierta, por vía medial, y posterior; cada una de ellas ofrece ventajas y desventajas. Mazzacaro et al (12) , no hallaron diferencias significativas entre ambas vías de abordaje, observandosé buenos resultados para ambas. Hoelting et al (15) describieron el valor de la terapia lítica con urokinasa preoperatoria.…”

Section: Discussionunclassified

Aneurismas de la Arteria Poplitea: Revisión bibliográfica y presentación de un caso

Cecenarro

Allende

Molinelli

et al. 2018

Rev Fac Cien Med Univ Nac Cordoba

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. Resumen:Introducción: El aneurisma de la arteria poplítea (AAP) es la dilatación localizada e irreversible de las paredes de la Arteria Poplítea. Es patología poco frecuente, constituye la segunda ubicación más frecuente de aneurismas verdaderos luego de los aórticos, y la primera ubicación dentro de los aneurismas periféricos. Se caracteriza por afectar a principalmente a hombres a una edad promedio de 65 años, cuyas manifestaciones son principalmente de origen isquémico, acabando en amputación del miembro inferior en una frecuencia que oscila según los casos entre un 7 y un 20 por ciento. Nuestro objetivo es realizar la presentación de un caso de AAP con isquemia arterial subaguda, junto con una actualización bibliográfica del tema. Presentación de caso: Se presenta el caso de un paciente de 63 años de edad quien consultó por dolor de miembro inferior 96 horas de evolución, con ausencia de pulsos. Se realizó el diagnóstico de isquemia subaguda evolucionada, no resvascularizable en el contexto de un paciente clínicamente inestable. Se decide amputación de urgencia. En la disección se objetiva la presencia de un AAP. Discusión: Los AAP tienen una incidencia de entre el 0,1 al 1%, presentan clínica variable. La arteriografía es gold standard para su diagnóstico. El tratamiento de elección es quirúrgico, presentándose nuevas opciones terapéuticas. Las variaciones anatómicas de las ramas de la AP son una variable a considerar. Los aneurismas asociados con mayor frecuencia son los poplíteos contralaterales (57,1%). Conclusiones: Concluimos que nuestra conducta fue adecuada considerando el estado del paciente.Palabras clave: aneurisma de la arteria poplítea; reporte de caso; revisión bibliográfica. Abstract:Introduction: The popliteal artery aneurysm (AAP) is localized and irreversible walls of the popliteal artery dilation. It is rare pathology is the second most common location of true aneurysms after aortic, and the first location within the peripheral aneurysms. It is characterized by affecting mainly men at an average age of 65, whose manifestations are mainly ischemic, finishing lower limb amputation in a frequency ranging as appropriate between 7 and 20 percent. Our goal is to make the presentation of a case of AAP with subacute arterial ischemia, along with a literature review of the topic. Case presentation: the case of a 63 year old who consulted for lower limb pain 96 hours of evolution, with absence of pulses is presented a diagnosis of advanced subacute ischemia was performed resvascularizable not in the context of a clinically unstable patient. emergency amputation is decided. In dissecting the presence of PSA objective. Discussion: The AAP have an incidence of 0.1 to 1%, have variable clinical. Arteriography is the gold standard for diagnosis. The treatment of choice is surgical, presenting new therapeutic options. The anatomical variations of the branches of the PA are variable to consider. Aneurysms are most commonly associated with contralateral popliteal (57.1%). Conclusions: We conclude that our...

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Section: Discussionunclassified

Aneurismas de la Arteria Poplitea: Revisión bibliográfica y presentación de un caso

Cecenarro

Allende

Molinelli

et al. 2018

Rev Fac Cien Med Univ Nac Cordoba

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“…There was a similar postoperative nerve and wound complication ratio in both groups. Only the in-hospital stay after PA was signi icantly lower [18,19].…”

Section: Introductionmentioning

confidence: 90%

Management of Popliteal Artery aneurysms: Experience in our center

Philippe¹

2018

Arch Vas Med

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Background: Popliteal artery aneurysms (PAAs) are rare, but the diagnosis should not be missed because of the limb and life threatening complications. The purpose of this study was to reach a consensus about the management of PAA based on our own experience and the available literature. Materials and Methods: This is a retrospective analysis of all patients who underwent an open surgical PAA repair at our institution from January 2015 to December 2016. Demographic data, risk factors, clinical presentation, aneurysm characteristics, type of repair and results were reviewed. Results include patency and major complications. Results: Seven patients underwent an open surgical PAA repair (six men). Median age was 72 years. A posterior approach (PA) was chosen four times and a medial approach (MA) was chosen three times. We performed six resections with interposition of a graft and only one ligation with a bypass. Five patients recovered well, did not develop any complication and did not need a second intervention to guarantee patency. These patients underwent a resection of the aneurysm and interposition of a graft (four via a PA and one via a MA). One patient treated by resection and interposition of a Dacron graft via a MA underwent an above-the-knee amputation at postoperative day 14. This patient had a preoperatively dysfunctional leg since several months with no patent outfl ow vessels. Our patient treated by ligation and bypass via a MA, developed an acute ischemia four months postoperatively because of an extreme fl exion of the knee during several hours while watching TV. After unsuccessful trombolysis, he underwent a femorotibial bypass and a partial forefoot amputation. No longterm results are yet available. Conclusions: In our opinion, open surgical repair of PAAs by resection of the aneurysm and interposition of a venous graft has the best results. Depending on the relation to the knee joint and thus the accessibility of the aneurysm, a posterior approach is preferred. We are not convinced of endovascular techniques in the treatment of popliteal artery aneurysms.

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“…La clínica de los AAP es variable, los pacientes pueden presentar síntomas oclusivos crónicos o agudos, por trombosis o embolia, síntomas compresivos del nervio ciático poplíteo o presentarse totalmente asintomáticos en hasta el 40% de los pacientes (6)(7)(8)(9)(10)(11)(12)(13)(14) . Al diagnóstico se llega con la clínica y el uso de métodos complementarios.…”

Section: Imagen 2 Relaciones Anatómicas De La Arteria Popliteaunclassified

Section: Imagenunclassified