Outcome of Open and Endovascular Repair in Patients with Acute Limb Ischemia Due to Popliteal Artery Aneurysm

Wrede, Axel; Acosta, Stefan

doi:10.1016/j.avsg.2020.03.019

Cited by 3 publications

(3 citation statements)

References 26 publications

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“…However, studies comparing the therapeutic efficiency of open surgery and endovascular intervention for thrombotic PAA with ALI after thrombolysis or thrombectomy are rare. Axel Wrede et al [33] compared the therapeutic effect of open and endovascular intervention in patients with PAA-related ALI, including 20 cases of open surgery and 19 cases of endovascular intervention. However, there was no significant difference between the two groups in the primary or secondary patency rates within the 30-day, 1-year and 2-year follow-up postoperative periods.…”

Section: Discussionmentioning

confidence: 99%

Comparisons of outcomes of open surgery versus endovascular intervention for thrombotic popliteal artery aneurysm with acute lower limb ischemia: a systematic review

Xiao

Ran

Wang³

et al. 2022

BMC Surg

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Background Thrombotic popliteal artery aneurysm (PAA) with acute lower limb ischemia (ALI) is a serious disease leading to amputation. The choice of emergency procedures is not clearly defined, and the difference in therapeutic efficiency between open surgery and endovascular intervention is still unclear. Method We conducted a comprehensive search through PubMed, Wiley Online Library and ScienceDirect. According to the predefined inclusion and exclusion criteria, eligible articles were screened out, and all relevant data were extracted for further analysis. Our study was designed and developed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guideline. We critically assessed all included articles by Joanna Briggs Institute (JBI) Critical Appraisal Checklists and the Methodological Index for Non-Randomized Studies (MINORS). Result A total of 29 articles (1338 patients/1387 limbs) were included in the study. After a 1-year follow-up, the primary patency rate of the open surgery group was significantly lower than that of the endovascular intervention group (72.65 vs. 81.46%, P = 0.004), but without significant difference in the secondary patency rate (86.19 vs. 86.86%, P = 0.825). The limb salvage rate of the open surgery group was also significantly lower (83.07 vs. 98.25%, P < 0.001). After the 2-year follow-up, the primary patency rate of the open surgery group was still significantly lower (48.57 vs. 59.90%, P = 0.021). Conclusion The outcome of endovascular intervention was better than that of open surgery especially in the 1-year limb salvage rate and primary patency rate at the 1-year and 2-year follow-ups.

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Section: Discussionmentioning

confidence: 99%

Comparisons of outcomes of open surgery versus endovascular intervention for thrombotic popliteal artery aneurysm with acute lower limb ischemia: a systematic review

Xiao

Ran

Wang³

et al. 2022

BMC Surg

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“…(2) landing zone at least 20 mm both proximal and distal to the aneurysmal lesion; (3) stent graft diameter being 5-20% larger than the healthy vessel diameter immediately proximal and distal to the lesion (oversizing); (4) if two or more stent grafts are used, stent graft should overlap at least 20 mm; (5) if stent grafts of different sizes are used, stent graft with larger diameter should be telescoped into stent graft with a smaller diameter; (6) the diameter of two overlapping stent grafts should not differ more than 1 mm (exception when using a 13 mm diameter stent graft to overlap with a 11 mm diameter stent graft); (7) an overlapping stent graft should not end in the "No Overlap Zone".…”

Section: Instructions For Usementioning

confidence: 99%

“…At Vascular Center, Sk ˚ane University Hospital, Malm€ o, Sweden, there has been an increase in the use of ER of PAA during the last decade. 5 Retrospective studies from this center have shown that the decision for choosing ER or OR when treating PAA is based on the discretion of the vascular surgeon in the majority of cases. 5,6 Though Instruction For Use (IFU) are provided by stent graft manufacturers, there is no standardized protocol for when to choose ER or OR, respectively.…”

Section: Introductionmentioning

confidence: 99%

Adherence to instruction for use after endovascular repair of popliteal artery aneurysm

et al. 2021

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Objectives Endovascular repair (ER) of popliteal artery aneurysm (PAA) is an alternative to open repair. However, there is no standardized protocol for when to opt for ER and the decision is therefore at the discretion of the clinician. This study aims to evaluate the adherence to the Instruction For Use (IFU) in patients undergoing ER for PAA and factors associated with stent graft patency at one year. Methods The adherence to IFU provided by the manufacturer in 55 patients treated with Gore Viabahn® Endoprosthesis with Heparin Bioactive Surface for PAA between 2009 and 2019 were retrospectively analyzed. Duplex follow-up was performed at 30 days and one year. Results The two groups of patients treated within ( n = 10) and not within ( n = 45) IFU did not differ in patient demographics, diagnostic assessment, treatment or outcome. Forty-five patients (81.8%) received stent graft placement with at least one deviation according to IFU. Distal oversizing >20% was the most frequent deviation against IFU ( n = 22, 40.0%). Primary patency at one year was 72%. Diameter size difference >1 mm between overlapping stent grafts (6/14 [43%], p = 0.013) and renal insufficiency (5/12 [42%], p = 0.0086) were associated with lower primary patency at one year. Age-adjusted analysis of tortuosity index (HR 1.78/SD, 95% CI 1.17–2.71; p = 0.0071) and maximal PAA angle (HR 1.73/SD, 95% CI 1.018–2.95; p = 0.043) were associated with major amputation/mortality at end of follow-up. Conclusion The majority of patients undergoing ER for PAA were not treated within IFU. Diameter size difference >1 mm between overlapping stent grafts was associated with a higher loss of primary patency at one year. Multi-center studies with larger sample size and long-term follow up of patency are warranted.

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The Combination of Vacuum-Assisted Thromboaspiration and Covered Stent Graft for Acute Limb Ischemia due to Thromboembolic Complications of Popliteal Aneurysm

Donato¹,

Pasqui²,

Galzerano³

et al. 2023

Annals of Vascular Surgery

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Outcome of Open and Endovascular Repair in Patients with Acute Limb Ischemia Due to Popliteal Artery Aneurysm

Cited by 3 publications

References 26 publications

Comparisons of outcomes of open surgery versus endovascular intervention for thrombotic popliteal artery aneurysm with acute lower limb ischemia: a systematic review

Comparisons of outcomes of open surgery versus endovascular intervention for thrombotic popliteal artery aneurysm with acute lower limb ischemia: a systematic review

Adherence to instruction for use after endovascular repair of popliteal artery aneurysm

The Combination of Vacuum-Assisted Thromboaspiration and Covered Stent Graft for Acute Limb Ischemia due to Thromboembolic Complications of Popliteal Aneurysm

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