Department of Vascular Surgery, University of Florence, Firenze, Italy.
Eur J Vasc Endovasc Surg. 2013 Apr;45(4):357-63. doi: 10.1016/j.ejvs.2013.01.012. Epub 2013 Feb 4.
The aim of this study was to analyse early and follow-up results of the treatment of popliteal artery aneurysms (PAAs) performed with open surgical repair or with endovascular exclusion with endografts in a multicentric retrospective registry involving seven Italian vascular centres.
We retrospectively collected data concerning 178 open surgical interventions (OR group) and 134 endovascular exclusions (ER group) for PAAs performed between January 2000 and December 2011. Early and follow-up results were analysed in terms of mortality, graft patency, reintervention and limb preservation.
OR patients were more frequently symptomatic (64%, 115 cases) than patients in the ER group (34%, 51 cases; p < 0.001), had more frequently acute limb ischaemia (23% and 6.5%, respectively; p < 0.001) and had more frequently a run-off score <2 (39% and 26%, respectively, p = 0.03). In the OR group there were no perioperative deaths; six thromboses (3.3%) and one amputation occurred. In the ER group mortality was 1.5%; 13 thromboses (9.7%) and one amputation (0.5%) occurred. Mean duration of follow-up was 30.6 ± 27.5 months. In the OR group primary and secondary patency, freedom from reintervention and limb preservation rates at 48 months were 63.5% (standard error (SE) 0.05), 76.5% (SE 0.05), 72.5% (SE 0.06) and 89.7% (SE 0.05), respectively. The corresponding figures in the ER group were 73.4% (SE 0.04), 85% (SE 0.04), 75% (SE 0.04) and 97% (SE 0.04), respectively.
In this large multicentric retrospective registry, open and endovascular treatment of PAAs are used in different patients with regard to clinical and anatomical characteristics. Both treatments are feasible and safe, providing satisfactory early and long-term results.
本研究旨在通过包含七个意大利血管中心的多中心回顾性注册研究，分析采用开放手术修复或血管内支架植入治疗腘动脉动脉瘤（PAAs）的早期和随访结果。
我们回顾性收集了 2000 年 1 月至 2011 年 12 月间，178 例接受开放手术治疗（OR 组）和 134 例接受血管内治疗（ER 组）的 PAAs 患者的数据。分析了死亡率、移植物通畅率、再次干预和肢体保存的早期和随访结果。
OR 组患者的症状发生率（64%，115 例）高于 ER 组（34%，51 例；p<0.001），急性肢体缺血的发生率（23%和 6.5%；p<0.001）和流出道评分<2 的发生率（39%和 26%；p=0.03）也更高。OR 组围手术期无死亡病例；发生 6 例血栓形成（3.3%）和 1 例截肢。ER 组死亡率为 1.5%；发生 13 例血栓形成（9.7%）和 1 例截肢（0.5%）。平均随访时间为 30.6±27.5 个月。OR 组患者的 48 个月时的主要通畅率、次要通畅率、免于再次干预率和肢体保存率分别为 63.5%（标准误 0.05）、76.5%（标准误 0.05）、72.5%（标准误 0.06）和 89.7%（标准误 0.05）。ER 组的相应数据分别为 73.4%（标准误 0.04）、85%（标准误 0.04）、75%（标准误 0.04）和 97%（标准误 0.04）。
在这项大型多中心回顾性注册研究中，开放手术和血管内治疗 PAAs 分别应用于不同临床和解剖特征的患者，两种治疗方法均安全可行，能提供满意的早期和长期结果。
