Clinical Outcome of Acute Leg Ischaemia Due to Thrombosed Popliteal Artery Aneurysm: Systematic Review of 895 Cases

Kropman, R.H.J.; Schrijver, A. Marjolein; Kelder, Johannes C.; Moll, F.L.; Vries, J.P.P.M. de

doi:10.1016/j.jvs.2010.02.271

Cited by 26 publications

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“…In agreement with the present results, a study by Seeger et al, 11 who examined predictive factors of major amputation in patients with critical limb ischaemia, runoff was identified as the most powerful predictor of amputation in the global patient series, as well as in those who underwent major amputation with patent bypass grafts. Similarly, in a systematic review conducted in 2010 by Kropman et al of bypass for thrombosed popliteal aneurysm, 12 it was shown that in the presence of poor runoff, the improvement in bypass patency recorded in patients with thrombolysis before surgery did not result in a lower amputation rate. This would explain the greater amputation rates in the present study, despite similar patency rates.…”

Section: Discussionmentioning

confidence: 94%

Results of Infrainguinal Bypass in Acute Limb Ischaemia

Marino

López

Suero

et al. 2016

European Journal of Vascular and Endovascular Surgery

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Section: Discussionmentioning

confidence: 94%

Results of Infrainguinal Bypass in Acute Limb Ischaemia

Marino

López

Suero

et al. 2016

European Journal of Vascular and Endovascular Surgery

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“…However, among other peripheral artery aneurysms, they are the most frequent type with an incidence rate of 0,1-2,8% (4,5). They account for 70% of peripheral artery aneurysms (1,3) and are bilaterally seen in half of the patients (3).…”

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confidence: 99%

“…PAA usually follows a clinically asymptomatic course though it may still bring about serious complications such as loss of extremities or even lives (4,5). Most serious complication are acute thrombosis, distal embolization, and, though uncommon, popliteal vein thrombosis due to rupture and local compression (1-4).…”

mentioning

confidence: 99%

“…Factors affecting the decision to intervene PAA are the incidence and speed of symptoms, size of aneurysm in diameter, mural thrombus, and the presence of thromboembolic history (1,3,4). Many authors recommend elective intervention in terms of thromboembolic risks for mural thromboses larger than 20 mm in asymptomatic patients (5,10). Patients with untreated PAAs tend to have an increased risk of complications over time; Galland et al's study has put forward that asymptomatic PAA has the risk of becoming symptomatic by 14% annually (11).…”

mentioning

confidence: 99%

“…For patients presenting with acute limb ischemia, preoperative implementation of thrombolytic therapy followed by bypass or stent application is another treatment option (2). While thrombolytic therapy is suggested for Rutherford class I-IIa patients with acute ischemia, it is not not recommended in patients with Rutherford class IIb-III (patients with motor or sensory loss) as this option is seen as a waste of time (3,5). Krop et al's study has found out that preoperative or intraoperative thrombolytic implementation has significant impact on reducing rate of amputation.…”

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confidence: 99%

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The Case of a Patient with Concomitant Popliteal Artery and Ascending Aortic Aneurysm Who Presented with the Blue Toe Syndrome

2015

J Turgut Ozal Med Cent

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Popliteal artery aneurysms (PAAs) are rare though these aneurysms are the most frequently encountered peripheral arterial aneurysms. In this article, we present the treatment of a patient who simultaneously had bilateral popliteal artery and ascending aortic aneurysm but was admitted to the emergency room due to the blue toe syndrome. A 72-old-year female was admitted to the hospital with left lower extremity pain and cyanosis in her toe. Bilateral popliteal artery and ascending aortic aneurysm were observed on computed tomography. Aneurysmectomy and femoropopliteal bypass was performed primarily to the left popliteal artery owing to ischemia. Two months later, we performed valve and ascending aorta replacement followed by right popliteal aneurysmectomy and femoropopliteal bypass 16 months later. In conclusion, since other arterial aneurysms can be simultaneously observed with popliteal artery aneurysm, it is very important to scan whole main arterial system when PAA is evaluated.

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Thrombolysis or Immediate Surgery for Thrombosed Popliteal Aneurysms?

Gibbons¹

2010

European Journal of Vascular and Endovascular Surgery

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The major risk of popliteal aneurysms is thrombosis, which is usually associated with tibial vessel embolisation. This may occur silently or cause claudication but frequently results in acute limb ischaemia. The prevalence of popliteal aneurysms in the general population and the proportion that cause acute limb ischaemia are unknown, so the risk of acute ischaemia is difficult to quantify. Nevertheless, elective exclusion bypass is usually advised for symptomatic aneurysms or those greater than 2 cm in diameter, 1 although some advocate a threshold of 3 cm. 2 This is based on the better outcome of elective than emergency treatment in case series. In the Swedish Vascular Registry, amputation rates were 17% for emergency and 4% for elective bypass, and 12% for symptomatic compared with 1.8% for asymptomatic aneurysms. 3 Because popliteal aneurysms are relatively uncommon, there have been no large randomised trials and outcome data are limited to case series and registries. Some thrombosed aneurysms inevitably present too late for limb salvage but most with a threatened limb undergo emergency bypass. Despite this, some suffer major amputation, usually because of failure to clear thrombus from the runoff vessels with balloon catheters. Preoperative thrombolysis under X-ray control is, therefore, particularly attractive. However, complete lysis may take several

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Clinical Outcome of Acute Leg Ischaemia Due to Thrombosed Popliteal Artery Aneurysm: Systematic Review of 895 Cases

Cited by 26 publications

References 0 publications

Results of Infrainguinal Bypass in Acute Limb Ischaemia

Results of Infrainguinal Bypass in Acute Limb Ischaemia

The Case of a Patient with Concomitant Popliteal Artery and Ascending Aortic Aneurysm Who Presented with the Blue Toe Syndrome

Thrombolysis or Immediate Surgery for Thrombosed Popliteal Aneurysms?

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