Deciphering Popliteal Artery Aneurysm Patient Diversity: Insights From a Cluster Analysis of the POPART Registry.

Autor: Leinweber ME; FIFOS-Forum for Integrative Research and Systems Biology Vienna Austria.; Department of Vascular and Endovascular Surgery, Klinik Ottakring Vienna Austria., Schmandra T; Department of Vascular Surgery, Sana Klinikum Offenbach Offenbach Germany., Karl T; Department of Vascular and Endovascular Surgery, Klinikum am Plattenwald, SLK-Kliniken Heilbronn GmbH Bad Friedrichshall Germany., Torsello G; Department for Vascular Surgery Franziskus Hospital Münster Münster Germany., Böckler D; Department of Vascular and Endovascular Surgery University Hospital Heidelberg Heidelberg Germany., Walensi M; Department of Vascular Surgery and Phlebology, Contilia Heart and Vascular Center Essen Germany., Geisbuesch P; Department of Vascular and Endovascular Surgery, Klinikum Stuttgart Stuttgart Germany., Schmitz-Rixen T; German Society of Surgery, Langenbeck-Virchow-Haus Berlin Germany., Jung G; Department of Vascular and Endovascular Surgery, Luzerner Kantonsspital Lucern Switzerland., Hofmann AG; FIFOS-Forum for Integrative Research and Systems Biology Vienna Austria.; Department of Vascular and Endovascular Surgery, Klinik Ottakring Vienna Austria.
Jazyk: angličtina
Zdroj: Journal of the American Heart Association [J Am Heart Assoc] 2024 Jun 18; Vol. 13 (12), pp. e034429. Date of Electronic Publication: 2024 Jun 15.
DOI: 10.1161/JAHA.124.034429
Abstrakt: Background: Popliteal artery aneurysms (PAAs) are the most common peripheral aneurysm. However, due to its rarity, the cumulative body of evidence regarding patient patterns, treatment strategies, and perioperative outcomes is limited. This analysis aims to investigate distinct phenotypical patient profiles and associated treatment and outcomes in patients with a PAA by performing an unsupervised clustering analysis of the POPART (Practice of Popliteal Artery Aneurysm Repair and Therapy) registry.
Methods and Results: A cluster analysis (using k-means clustering) was performed on data obtained from the multicenter POPART registry (42 centers from Germany and Luxembourg). Sensitivity analyses were conducted to explore validity and stability. Using 2 clusters, patients were primarily separated by the absence or presence of clinical symptoms. Within the cluster of symptomatic patients, the main difference between patients with acute limb ischemia presentation and nonemergency symptomatic patients was PAA diameter. When using 6 clusters, patients were primarily grouped by comorbidities, with patients with acute limb ischemia forming a separate cluster. Despite markedly different risk profiles, perioperative complication rates appeared to be positively associated with the proportion of emergency patients. However, clusters with a higher proportion of patients having any symptoms before treatment experienced a lower rate of perioperative complications.
Conclusions: The conducted analyses revealed both an insight to the public health reality of PAA care as well as patients with PAA at elevated risk for adverse outcomes. This analysis suggests that the preoperative clinic is a far more crucial adjunct to the patient's preoperative risk assessment than the patient's epidemiological profile by itself.
Databáze: MEDLINE
Externí odkaz: