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

Autor: Stefan Acosta, Axel Wrede
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Time Factors
030204 cardiovascular system & hematology
Risk Assessment
Amputation
Surgical
030218 nuclear medicine & medical imaging
law.invention
03 medical and health sciences
Blood Vessel Prosthesis Implantation
0302 clinical medicine
Randomized controlled trial
law
Ischemia
Risk Factors
medicine
Humans
In patient
Popliteal Artery
Risk factor
Aged
Retrospective Studies
Aged
80 and over
business.industry
Proportional hazards model
Endovascular Procedures
Popliteal artery aneurysm
Atrial fibrillation
General Medicine
biochemical phenomena
metabolism
and nutrition
Middle Aged
medicine.disease
Limb Salvage
Limb ischemia
Aneurysm
Abdominal aortic aneurysm
Surgery
Blood Vessel Prosthesis
Treatment Outcome
Acute Disease
Female
Stents
Cardiology and Cardiovascular Medicine
business
Zdroj: Annals of vascular surgery. 67
ISSN: 1615-5947
Popis: Background Popliteal artery aneurysm (PAA) carries a risk of sudden thromboembolism, resulting in acute limb ischemia (ALI). Since 2010, all 65 year-old-men in Region Skane are invited for abdominal aortic aneurysm (AAA) screening, and subsequently for PAA if AAA is detected. The aims of the study were to explore if the ratio of PAAs treated electively compared with acute has changed since the implementation of the AAA screening program and to investigate the risk factors for major amputation, mortality, and combined major amputation/mortality after acute open repair (OR) or endovascular repair (ER) for PAA with ALI. Method Medical charts of patients treated for PAA between January 1, 2009 and February 1, 2019 were identified by the International Classification of Diseases, 10th revision code I72.4. Data gathered into a preset database. A multivariable Cox regression analysis was used to identify independent risk factors for major amputation/mortality. Results There was an increase in PAAs treated electively (n = 84) compared with acute (n = 41) during the study period (P = 0.014). Four (17.8%) electively treated patients with PAA of 23 eligible were detected because of AAA screening. No patient in the ER group underwent major amputation after a median follow-up time of 30 months. At the end of follow-up, there was no difference in major amputation/mortality (P = 0.64) between patients with ALI receiving OR or ER, respectively. Only atrial fibrillation was identified as an independent risk factor for mortality (P = 0.003). Conclusions The increase in elective PAA repair was not a consequence of AAA screening. The zero major amputation rate after ER in ALI due to PAA at mid-term was unexpectedly low. A randomized controlled trial between OR and ER is warranted.
Databáze: OpenAIRE
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