Comparisons of outcomes of open surgery versus endovascular intervention for thrombotic popliteal artery aneurysm with acute lower limb ischemia: a systematic review

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.

Symptomatic Popliteal Artery Aneurysms in Recently SARS-CoV-2-Infected Patients: The Microangiopathic Thrombosis That Undermines Treatment

“…In fact, a metanalysis by Xiao et al including 32 papers on thrombosed PAA highlighted an overall technical success rate of 90.73% without any significant difference between the open surgery and endovascular intervention groups, while the primary patency rate and the limb salvage rate at 1-year follow-up was significantly lower in the open group, when compared to the endovascular route [13].…”

Acute Popliteal Artery Thrombotic Occlusion Post Total Knee Arthroplasty in a Patient With Antiphospholipid Syndrome: A Report of a Rare Complication

“…Arterial injury following TKA has traditionally been managed through open surgery, however, recent studies showed promising results with endovascular strategies. Endovascular treatment has the advantage of avoiding general anesthetics with less local morbidity than open surgery [ 7 , 24 , 27 , 28 ]. The type of endoscopic intervention depends on the type of arterial injury.…”