[Management of popliteal artery pseudoaneurysms as a result of limb trauma and orthopedic surgery or associated with osteochondromas].

Autor: Raherinantenaina F; Service de chirurgie vasculaire, CHU Morafeno, Toamasina, Madagascar. Electronic address: heryfano@yahoo.fr., Rajaonanahary TM; Service de chirurgie vasculaire, CHU Morafeno, Toamasina, Madagascar., Rakoto Ratsimba HN; Service de chirurgie générale et vasculaire, CHU/HJRA, Tananarive, Madagascar.
Jazyk: francouzština
Zdroj: Annales de cardiologie et d'angeiologie [Ann Cardiol Angeiol (Paris)] 2016 Sep; Vol. 65 (4), pp. 265-74. Date of Electronic Publication: 2016 May 25.
DOI: 10.1016/j.ancard.2016.04.023
Abstrakt: Most published articles regarding popliteal artery pseudoaneurysms (PAPs) are case reports and in English language literature. In this context, no study with robust data was previously published. The exact epidemiology of these APs is not well-known and their management is not yet codified. We wanted to summarize the current knowledge on diagnostic and therapeutic features of PAPs as a result of limb trauma and orthopedic surgery or associated with osteochondromas. An electronic research on MEDLINE and EMBASE between 1953 and March 2015 was performed; using the key words "popliteal pseudoaneurysm". The referenced articles were selectively read and this systematic review included 116 articles. Patient demographics; clinical presentations; diagnostic and therapeutic features were reviewed. In sum, 122 cases were analyzed. Overall young adult (average age=30.48±21.25 years old) represented the majority of the affected population with a masculine preponderance (79%). The main etiologies included femoral exostosis (63%), followed by the orthopedic surgery (25%) and direct trauma into the knee (10%). Painful swelling (44%) and/or pulsatile mass (39%) represented the most commonly presenting symptoms. The commonest radiological investigations used included arteriography (49%) and CTA (27%). The treatment was open surgical repair (85%) or endovascular stenting graft (14%). Post-therapeutic courses were often uneventful (98%). The morbidity rate was low at about 2%. The treatment of direct post-traumatic PAPs was usually open surgical repair (83%) with saphenous vein grafting. Endovascular stenting may be an ideal option for managing PAPs following orthopedic surgery (88%). Open surgery for vascular repair and maximum exostectomy must be undertaken concomitantly in the setting of APs associated with osteochondromas.
(Copyright © 2016 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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