Success of thrombolysis as a predictor of outcome in acute thrombosis of popliteal aneurysms

Marty, Bettina; Wicky, Stéphan; Ris, Hans‐Beat; Mueller, Xavier M.; Fischer, A.; Hayoz, Daniel; Segesser, Ludwig Karl von

doi:10.1067/mva.2002.119228

Cited by 46 publications

(38 citation statements)

References 28 publications

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“…Similarly, Sarcina et al , in 67 patients, reported 10‐year patency and LS rates of 78.2 and 87.4%, respectively, in asymptomatic patients, compared with 67.2 and 74.6% in patients with critically ischaemic limbs 19 . Other authors have reported that no limb loss occurred after operative treatment in asymptomatic patients 7,13,18,23 …”

Section: Management Optionsmentioning

confidence: 89%

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Management of Popliteal Artery Aneurysms

Hamish

Lockwood

Cosgrove

et al. 2006

ANZ Journal of Surgery

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1. Although most PAA are of atherosclerotic origin in old patients, trauma, infection and family history are the main causes in young patients. 2. Great vigilance is needed for diagnosis as only approximately five patients are seen each year by a major vascular centre. There is no place for screening programmes to detect PAA. 3. Approximately 45% of patients are asymptomatic at the time of initial diagnosis. Aortic aneurysms are found in 40% and bilateral PAA in 50% of patients. More than 95% of patients are men with a mean age of 65 years and 45% have hypertension. 4. Surgical reconstruction is recommended for all symptomatic and asymptomatic aneurysms larger than 2 cm. Five-year graft patency rates after surgical repair range from 30 to 97%, with 5-year limb salvage ranging from 70 to 98%. Patient survival rates at 5 and 10 years are 75 and 46%, respectively. 5. If carried out carefully, intra-arterial thrombolysis can safely prepare patients presenting with acute ischaemia from occluded PAA, for surgical revascularization to restore distal run-off. 6. Endovascular repair of a PAA is a feasible option, although little evidence is yet available. 7. Lifelong, careful patient surveillance is essential to detect and treat new aneurysms at other sites.

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Section: Management Optionsmentioning

confidence: 89%

“…19 Other authors have reported that no limb loss occurred after operative treatment in asymptomatic patients. 7,13,18,23 Various approaches can be taken in the surgical repair of PPA. A medial approach is often used in limbs with acute and chronic ischaemias.…”

Section: Surgical Interventionmentioning

confidence: 99%

Management of Popliteal Artery Aneurysms

Hamish

Lockwood

Cosgrove

et al. 2006

ANZ Journal of Surgery

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“…Overall, in patients with PAA, limbthreatening ischemia has been documented to occur in 17-46% and rupture in 3%. 6,8,[16][17][18][19][20][21] Limb loss from complications of PAA has been observed in as high as 67%. 7,[22][23][24][25] Some have suggested reserving operation for only those with symptoms who were deemed appropriate surgical candidates.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of surgical management for popliteal artery aneurysms: An analysis of 583 cases

Johnson

Slidell

Macsata

et al. 2008

Journal of Vascular Surgery

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“…Some authors have even recommended primary amputation when thrombolysis fails to restore tibial vessel patency in the presumed setting of chronic embolization. Marty 23 found that lysis was unsuccessful in 23% of the patients they treated with thrombosed aneurysms. In light of the dismal bypass results in these patients after unsuccessful lysis, primary amputation rather than revascularization was suggested.…”

Section: The Acutely Thrombosed Aneurysmmentioning

confidence: 97%

A Contemporary Review of Popliteal Artery Aneurysms

Wain

Hines²

2007

Cardiology in Review

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Popliteal artery aneurysms account for 85% of all peripheral aneurysms and are frequently associated with abdominal aortic aneurysms. Up to 75% of all popliteal artery aneurysms are discovered in symptomatic patients who present with arterial insufficiency, leg swelling, or pain. Popliteal artery aneurysms can be diagnosed with duplex ultrasonography. Aneurysm repair should be considered for all symptomatic patients with rest pain or limb-threatening symptoms. Asymptomatic aneurysms larger than 2 cm should also be treated to prevent the development of limb-threatening ischemia and assure better surgical bypass graft patency and longer freedom from amputation. Conventional aneurysm repair consists of either opening the aneurysm sac and interposing a bypass graft or aneurysm ligation combined with bypass grafting. If the aneurysm sac is left intact, side branch perfusion may persist and the aneurysm may continue to enlarge and can rupture. Endovascular popliteal aneurysm repair has not demonstrated clinical equipoise to standard surgery but may be advantageous in select high-risk patients.

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Success of thrombolysis as a predictor of outcome in acute thrombosis of popliteal aneurysms

Cited by 46 publications

References 28 publications

Management of Popliteal Artery Aneurysms

Management of Popliteal Artery Aneurysms

Outcomes of surgical management for popliteal artery aneurysms: An analysis of 583 cases

A Contemporary Review of Popliteal Artery Aneurysms

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