Real-world data of popliteal artery aneurysm treatment: Analysis of the POPART registry

Jung, G.; Leinweber, Maria-Elisabeth; Karl, Thomas R.; Geisbüsch, Philipp; Balzer, K.; Schmandra, T. C.; Dietrich, Tanja; Derwich, Wojciech; Gray, Daphne; Schmitz‐Rixen, Thomas

doi:10.1016/j.jvs.2021.12.079

Cited by 19 publications

(29 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Popliteal artery aneurysms (PAAs) are the most common peripheral arterial aneurysm, accounting for 70% of all peripheral aneurysms 1 , with an incidence of 10.4 cases per million inhabitants per year 2,3 . PAAs most commonly occur in 60- to 70-year-old men and are associated with presence of an abdominal aortic aneurysms (AAA) 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Definitive surgical repair options include the gold standard open surgical bypass with a venous conduit 3,7 or minimally invasive endovascular repair with covered stent placement 8 . While there is current debate surrounding which repair strategy is best, both open and endovascular repair of PAAs pose a risk of wound complications, need for additional procedures, and amputation 2,3,6,9 .…”

Section: Introductionmentioning

confidence: 99%

“…PAAs are associated with high limb amputation rates and mortality 2 , but operative repair also poses risk to patients. Therefore, the Society for Vascular Surgery (SVS) has published a set of guidelines for repair of high risk PAAs 9 .…”

Section: Introductionmentioning

confidence: 99%

“…The natural history studies available are from the 1990’s 1,15 or conducted in very small cohorts of patients 15 . Large contemporary studies are focused on comparing endovascular and open methods 6 , perioperative outcomes 2 , and long-term patency rates 6,11 . There has only been one study to our knowledge that attempted to identify a cutoff size associated with increased risk of thrombosis based on a threshold of 30-mm diameter and greater than 45 degrees of distortion, which is not a simple measurement that can be performed on routine DUS 16 .…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Percent Thrombus Outperforms Size in Predicting Popliteal Artery Aneurysm Related Thromboembolic Events

Bellomo,

Goudot,

Lella

et al. 2023

Preprint

View full text Add to dashboard Cite

IntroductionPopliteal artery aneurysms (PAAs) are associated with high morbidity and mortality and current Society for Vascular Surgery (SVS) recommend operative repair for PAAs with a diameter greater than 20 mm, which is based on limited evidence. To help risk stratify patients for surgery, our aim was to identify anatomic characteristics of PAA associated with limb threatening and thromboembolic events (TEs).MethodsA retrospective multi-institutional cohort was queried for all patients with a PAA from 2008 to 2022. Symptom status at the time of presentation was divided into three categories: symptomatic PAA with documented claudication or chronic limb ischemia (CLI), limb threatening PAA with a TE, acute limb ischemia, or rupture, and asymptomatic PAA without symptoms or limb threatening events. Patient and anatomic factors based on duplex ultrasound (DUS) were evaluated as potential predictors of symptom groups and thresholds of anatomic variables were identified using receiver operating characteristic curves.ResultsThere were 470 PAAs identified in 331 patients. The mean age was 74 years at diagnosis, 94% of patients were white, and 97% of patients were male. Cardiovascular comorbidities were prevalent in and similar between all patient groups studied, and almost all patients were on anticoagulation or antiplatelet therapy at the time of diagnosis, at 96%. The most common concurrent aneurysm was abdominal aortic aneurysm (62%). Patient comorbidities were not associated with symptom status. PAAs with a higher percent thrombus burden were 18 times more likely to experience a limb threatening event and 24 times more likely to experience a TE. A largest diameter threshold of 20.4 mm was predictive of a TE (sensitivity 78.1%, specificity 40.5%), but percent thrombus threshold of 62% outperformed largest diameter as a predictor of a TE (sensitivity of 81.3%, specificity 52.0%). Percent thrombus threshold of 73% also predicted limb threatening events (sensitivity 65.7%, specificity 69.7%).ConclusionA PAA diameter greater than 20.4 mm was predictive of TEs, which is in agreement with clinical practice guidelines. However, percent thrombus greater than 62% outperformed largest diameter as a predictor of a TE. This analysis supports the use of size greater than 20.4 mm and 62% thrombus in identifying high risk PAAs that warrant repair.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Percent Thrombus Outperforms Size in Predicting Popliteal Artery Aneurysm Related Thromboembolic Events

Bellomo,

Goudot,

Lella

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Die Studienergebnisse erfassen einen Beobachtungszeitraum von 24 Monaten, interessant wäre es jedoch, die Langzeitergebnisse zu korrelieren bei Hinweisen auf eine Angleichung der Ergebnisse ER vs. OR nach 3 Jahren bzw. im Langzeit-Follow-up [2] Das Plädoyer der Autoren, eine offen chirurgische Versorgung einer endovaskulären bei symptomatischen PAA vorzuziehen, ist dennoch konkordant zu den Ergebnissen des POPART-Registers, die sowohl in der Gesamtkohorte als auch insbesondere im Falle symptomatischer PAA eine Überlegenheit der offen chirurgischen PAA-Therapie zeigen [3] Die Ergebnisse dieser Studie werden außerdem durch die aktuellen klinischen Guidelines der Society for Vascular Surgery [4] gestützt. Jedoch bleibt zu betonen, dass mit Blick auf die immer noch spärliche Evidenzlage die Endovaskuläre PAA Therapie eine wertvolle Therapiealternative bleibt, die Indikation jedochinsbesondere im Falle einer akuten Extremitätenischämiestreng und als Einzelfallentscheidung gestellt werden muss.…”

unclassified

Offene vs. Endovaskuläre Behandlung bei Poplitealarterienaneurysma

2022

Gefäßmedizin Scan - Zeitschrift für Angiologie, Gefäßchirurgie,

View full text Add to dashboard Cite

Sex differences in outcomes after revascularization for acute lower limb ischemia: Propensity score adjusted analysis

Karonen,

Eek,

Butt

et al. 2024

World j. surg.

View full text Add to dashboard Cite

BackgroundPrevious reports have suggested higher rates of mortality and amputation for female patients in acute lower limb ischemia (ALI). The aims of the present study were to investigate if there is a difference in mortality, amputation, and fasciotomy between the sexes.MethodsA retrospective cohort study of consecutive patients undergoing index revascularization for ALI between 2001 and 2018 was conducted. A propensity score was created through a logistic regression with female/male sex as an outcome. Cox regression analyses for 90‐day and 1‐year mortality, combining major amputation/mortality, and logistic regression for major bleeding and fasciotomy, were performed. All analyses were performed with and without adjusting for propensity score.ResultsA total of 709 patients were included in the study of which 45.9% were women. Mean age was 72.1 years. Females were older and had higher rates of atrial fibrillation, embolic disease, and lower estimated glomerular filtration rate, while men more often had anemia and chronic peripheral arterial disease. Mortality at 1 year was 21.2% for women and 14.7% for men. The adjusted hazard ratio for 1‐year mortality was 0.99 (95% CI 0.67–1.46). Fasciotomy was performed in 7.1% of female and 12.8% of male patients; the adjusted odds ratio was 0.52 (95% CI 0.29–0.91).ConclusionSex was not found to be an independent risk factor for mortality or combined major amputation/mortality after revascularization for acute lower limb ischemia, whereas women had lower odds of undergoing fasciotomy. Whether women are underdiagnosed or do not develop acute compartment syndrome in the lower leg as often as men should be evaluated prospectively.

show abstract

Real-world data of popliteal artery aneurysm treatment: Analysis of the POPART registry

Cited by 19 publications

References 21 publications

Percent Thrombus Outperforms Size in Predicting Popliteal Artery Aneurysm Related Thromboembolic Events

Percent Thrombus Outperforms Size in Predicting Popliteal Artery Aneurysm Related Thromboembolic Events

Offene vs. Endovaskuläre Behandlung bei Poplitealarterienaneurysma

Sex differences in outcomes after revascularization for acute lower limb ischemia: Propensity score adjusted analysis

Contact Info

Product

Resources

About