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  • Grip, OliviaUppsala universitet,Kärlkirurgi (author)

Contemporary Treatment of Popliteal Artery Aneurysms in 14 Countries : A Vascunet Report

  • Article/chapterEnglish2020

Publisher, publication year, extent ...

  • Elsevier BV,2020
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-426371
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-426371URI
  • https://doi.org/10.1016/j.ejvs.2020.07.005DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Objective: Popliteal artery aneurysm (PAA) is the second most common arterial aneurysm. Vascunet is an international collaboration of vascular registries. The aim was to study treatment and outcomes. Methods: This was a retrospective analysis of prospectively registered population based data. Fourteen countries contributed data (Australia, Denmark, Finland, France, Hungary, Iceland, Italy, Malta, New Zealand, Norway, Portugal, Serbia, Sweden, and Switzerland). Results: During 2012-2018, data from 10 764 PAA repairs were included. Mean values with between countries ranges in parenthesis are given. The incidence was 10.4 cases/million inhabitants/year (2.4-19.3). The mean age was 71.3 years (66.8-75.3). Most patients, 93.3%, were men and 40.0% were active smokers. The operations were elective in 73.2% (60.0%-85.7%). The mean pre-operative PAA diameter was 32.1 mm (27.3-38.3 mm). Open surgery dominated in both elective (79.5%) and acute (83.2%) cases. A medial surgical approach was used in 77.7%, and posterior in 22.3%. Vein grafts were used in 63.8%. Of the emergency procedures, 91% (n = 2 169, 20.2% of all) were for acute thrombosis and 9% for rupture (n = 236, 2.2% of all). Thrombosis patients had larger aneurysms, mean diameter 35.5 mm, and 46.3% were active smokers. Early amputation and death were higher after acute presentation than after elective surgery (5.0% vs. 0.7%; 1.9% vs. 0.5%). This pattern remained one year after surgery (8.5% vs. 1.0%; 6.1% vs. 1.4%). Elective open compared with endovascular surgery had similar one year amputation rates (1.2% vs. 0.2%; p = .095) but superior patency (84.0% vs. 78.4%; p = .005). Veins had higher patency and lower amputation rates, at one year compared with synthetic grafts (86.8% vs. 72.3%; 1.8% vs. 5.2%; both p < .001). The posterior open approach had a lower amputation rate (0.0% vs. 1.6%, p = .009) than the medial approach. Conclusion: Patients presenting with acute ischaemia had high risk of amputation. The frequent use of endovascular repair and prosthetic grafts should be reconsidered based on these results.

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  • Mani, Kevin,1975-Uppsala universitet,Kärlkirurgi(Swepub:uu)kevma940 (author)
  • Altreuther, MartinSt Olavs Hosp, Dept Vasc Surg, Trondheim, Norway. (author)
  • Goncalves, Frederico BastosCtr Hosp Univ Lisboa Cent, Hosp Santa Marta, Lisbon, Portugal. (author)
  • Beiles, BarryAustralian & New Zealand Soc Vasc Surg, Melbourne, Vic, Australia. (author)
  • Cassar, KevinMater Dei Hosp, Dept Surg, Vasc Unit, Msida, Malta. (author)
  • Davidovic, LazarSerbian Clin Ctr, Clin Vasc & Endovasc Surg, Belgrade, Serbia. (author)
  • Eldrup, NikolajCopenhagen Univ Hosp, Dept Vasc Surg, Rigshosp, Copenhagen, Denmark. (author)
  • Lattmann, ThomasCantonal Hosp, Clin Vasc Surg, Winterthur, Switzerland. (author)
  • Laxdal, ElinLandspitalinn Univ Hosp, Dept Vasc Surg, Reykjavik, Iceland. (author)
  • Menyhei, GaborPecs Univ, Dept Vasc Surg, Med Ctr, Pecs, Hungary. (author)
  • Setacci, CarloUniv Siena, Siena, Italy. (author)
  • Settembre, NiclaUniv Lorraine, Nancy Univ Hosp, Dept Vasc & Endovasc Surg, Nancy, France. (author)
  • Thomson, IanUniv Otago, Dept Surg Sci, Dunedin, New Zealand. (author)
  • Venermo, MaaritHelsinki Univ Cent Hosp, Dept Vasc Surg, Helsinki, Finland. (author)
  • Björck, MartinUppsala universitet,Kärlkirurgi(Swepub:uu)mabjo425 (author)
  • Uppsala universitetKärlkirurgi (creator_code:org_t)

Related titles

  • In:European Journal of Vascular and Endovascular Surgery: Elsevier BV60:5, s. 721-7291078-58841532-2165

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