Popliteal Artery Aneurysm with Acute Ischemia in 229 Patients. Outcome after Thrombolytic and Surgical Therapy

Abstract

Objectives This study investigated the relationship between annual hospital volume and the outcomes in carotid endarterectomy and quantified critical volume threshold for this procedure.Data sources PubMed, EMBASE and the Cochrane library were searched for all articles on the volume-outcome relationship in CEA.Review methods Articles were included if they presented data on post-operative mortality and/or stroke rates and annual hospital volume of CEA. The review conformed to the QUOROM statement. The data were meta-analysed and a pooled effect estimate of volume on the stroke and/or mortality rates from CEA quantified, along with the critical volume threshold.Results Twenty-five articles, encompassing 936 436 CEA, were analysed. Significant relationships between mortality rate and stroke rate and annual volume were seen.Overall, the pooled effect estimate was odds ratio 0.78 [95% confidence interval 0.64 -0.92], in favour of surgery at higher volume units, with a critical volume threshold of 79 CEA per annum.Conclusions Significantly lower mortality and stroke rates were achieved at hospitals providing a higher annual hospital volume of CEA. Hospitals wishing to provide CEA should adhere to minimum volume criteria.

Treatment of Popliteal Aneurysm by Open and Endovascular Surgery: A Contemporary Study of 592 Procedures in Sweden

“…Ravn et al 1 reported 571 patients with 717 legs treated in Sweden in 1987e2002: preoperative thrombolysis improved run-off and reduced the risk of amputation when the patient presented with acute ischaemia, 2 and open repair (OR) with a posterior approach (often using the inlay technique) had better long-term results because of the reduced risk of late expansion. 3 It was not meaningful to compare OR and endovascular repair (ER) during this time period.…”

Popliteal Artery Aneurysm in Women

“…Data on the prevalence of multi-aneurysmal disease already existed in 1092 of the 1509 patients (72%), a result of previous investigations in 1987-2002 1,3,4 and 2008e 2012. 7 To study the frequency of multi-aneurysmal disease among the women operated on in 2003e2007, questionnaires were sent to the treating hospitals, asking about any diagnosis of additional aneurysmal disease and amputation until June 2012.…”

Long-term Outcome after Thrombolysis for Acute Lower Limb Ischaemia

“…28,29 PAAs often generate emboli that progressively occlude the distal arterial network, making thrombolysis a valuable first line approach, which later in elective settings can be followed by surgical repair of the aneurysm. 29,30 The poor patency rate after thrombolysis for occluded PAA, might be explained by incomplete runoff clearance of fresh and/or old embolic clots. This subgroup, however, had the best amputation free survival at 5 years and higher survival after 5 years.…”