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Xiao X, Feng R, Wang M, Sun H, Jing T, Su L, Fan Y, Hu Z, Wang S, Wang S. Comparisons of outcomes of open surgery versus endovascular intervention for thrombotic popliteal artery aneurysm with acute lower limb ischemia: a systematic review. BMC Surg 2022; 22:398. [PMCID: PMC9673418 DOI: 10.1186/s12893-022-01843-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 11/08/2022] [Indexed: 11/21/2022] Open
Abstract
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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Affiliation(s)
- Xixi Xiao
- grid.12981.330000 0001 2360 039XDepartment of Vascular Surgery, National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, The First Affiliated Hospital, Sun Yat-Sen University, No.58, Zhongshan 2nd road, Yuexiu District, Guangzhou, 510080 Guangdong China ,grid.12981.330000 0001 2360 039XZhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080 China
| | - Ruijia Feng
- grid.12981.330000 0001 2360 039XDepartment of Vascular Surgery, National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, The First Affiliated Hospital, Sun Yat-Sen University, No.58, Zhongshan 2nd road, Yuexiu District, Guangzhou, 510080 Guangdong China ,grid.12981.330000 0001 2360 039XZhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080 China
| | - Mingshan Wang
- grid.12981.330000 0001 2360 039XDepartment of Vascular Surgery, National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, The First Affiliated Hospital, Sun Yat-Sen University, No.58, Zhongshan 2nd road, Yuexiu District, Guangzhou, 510080 Guangdong China
| | - Hanqi Sun
- grid.12981.330000 0001 2360 039XDepartment of Vascular Surgery, National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, The First Affiliated Hospital, Sun Yat-Sen University, No.58, Zhongshan 2nd road, Yuexiu District, Guangzhou, 510080 Guangdong China ,grid.12981.330000 0001 2360 039XZhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080 China
| | - Tianzhen Jing
- grid.12981.330000 0001 2360 039XDepartment of Vascular Surgery, National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, The First Affiliated Hospital, Sun Yat-Sen University, No.58, Zhongshan 2nd road, Yuexiu District, Guangzhou, 510080 Guangdong China ,grid.12981.330000 0001 2360 039XZhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080 China
| | - Lianhua Su
- grid.12981.330000 0001 2360 039XDepartment of Vascular Surgery, National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, The First Affiliated Hospital, Sun Yat-Sen University, No.58, Zhongshan 2nd road, Yuexiu District, Guangzhou, 510080 Guangdong China
| | - You Fan
- grid.12981.330000 0001 2360 039XDepartment of Vascular Surgery, National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, The First Affiliated Hospital, Sun Yat-Sen University, No.58, Zhongshan 2nd road, Yuexiu District, Guangzhou, 510080 Guangdong China
| | - Zuojun Hu
- grid.12981.330000 0001 2360 039XDepartment of Vascular Surgery, National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, The First Affiliated Hospital, Sun Yat-Sen University, No.58, Zhongshan 2nd road, Yuexiu District, Guangzhou, 510080 Guangdong China
| | - Shenming Wang
- grid.12981.330000 0001 2360 039XDepartment of Vascular Surgery, National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, The First Affiliated Hospital, Sun Yat-Sen University, No.58, Zhongshan 2nd road, Yuexiu District, Guangzhou, 510080 Guangdong China
| | - Siwen Wang
- grid.12981.330000 0001 2360 039XDepartment of Vascular Surgery, National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, The First Affiliated Hospital, Sun Yat-Sen University, No.58, Zhongshan 2nd road, Yuexiu District, Guangzhou, 510080 Guangdong China
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Maeno R, Isaji T, Takayama T, Hoshina K. Popliteal artery aneurysm in a 14-year-old boy with tuberous sclerosis complex. J Vasc Surg Cases Innov Tech 2022; 9:100961. [PMID: 36794044 PMCID: PMC9922967 DOI: 10.1016/j.jvscit.2022.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/25/2022] [Indexed: 11/27/2022] Open
Abstract
Tuberous sclerosis complex (TSC) is rarely associated with aneurysms. We have described a patient with a popliteal artery aneurysm that was associated with TSC and occlusion of the right posterior tibial artery. The patient underwent aneurysm resection and vein graft replacement, with an uneventful postoperative course and no recurrence at 11 months of follow-up. Patients with TSC could have aneurysms in areas that will not be recognized on abdominal imaging. Physical examination of the lower extremities should be performed owing to the possibility of a popliteal artery aneurysm, and imaging studies should be performed if an aneurysm is suspected.
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Affiliation(s)
| | | | | | - Katsuyuki Hoshina
- Correspondence: Katsuyuki Hoshina, MD, PhD, Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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Murray CR, Bluemn EG, Judelson DR, Messina LM. Acute Limb Ischemia in a 26-Year-Old Man Presenting with an Idiopathic Thrombosed Popliteal Artery Aneurysm. Ann Vasc Surg 2019; 62:498.e7-498.e10. [PMID: 31449942 DOI: 10.1016/j.avsg.2019.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 10/26/2022]
Abstract
Popliteal artery aneurysms (PAAs) are the most common peripheral arterial aneurysms and develop almost exclusively (>90%) in men who have a history of tobacco abuse at an average age of 65 years. Most PAAs are caused by chronic inflammation secondary to atherosclerotic disease; other nondegenerative causes of PAAs include arterial trauma, infection, Behçet's disease, medial fibromuscular dysplasia, or popliteal artery entrapment. Few case reports have been published on idiopathic congenital PAAs. We report a case of a 26-year-old man who presented with progressive claudication and subsequent acute limb ischemia due to the thrombosis of a large idiopathic PAA. Our case demonstrates that the differential diagnosis of young adult or pediatric patients presenting with signs of acute limb ischemia or claudication should include a symptomatic PAA.
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Affiliation(s)
- Clark R Murray
- Division of General Surgery, University of Massachusetts Medical School, Worcester, MA.
| | - Eric G Bluemn
- Division of Vascular and Endovascular Surgery, University of Massachusetts Medical School, Worcester, MA
| | - Dejah R Judelson
- Division of Vascular and Endovascular Surgery, University of Massachusetts Medical School, Worcester, MA
| | - Louis M Messina
- Division of Vascular and Endovascular Surgery, University of Massachusetts Medical School, Worcester, MA
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