Wagenhäuser M U, Herma K B, Sagban T A, Dueppers P, Schelzig H, Duran M
Department of Vascular and Endovascular Surgery, University Hospital Düsseldorf, Germany, Moorenstraße. 5, 40225 Düsseldorf, Germany.
Ann Med Surg (Lond). 2015 Feb 11;4(1):58-63. doi: 10.1016/j.amsu.2015.01.005. eCollection 2015 Mar.
Popliteal artery aneurysms (PAA) are rare. Different surgical techniques for open surgical repair are possible. This study presents a single centre experience using open surgical repair with a medial approach (MA) and outlines differences between symptomatic (SLS) and asymptomatic (ALS) legs.
Data collection was performed retrospectively. The investigation period was from 1 January 1996 to 1 January 2013. Patients presented in the Outpatient Department and received a questionnaire concerning their quality of life. Data are presented as mean ± standard deviation. Mann-Whitney test and Cochran-Armitage test for trend was used for data analysis. Kaplan-Meier method was used to calculate limb salvage rates. p < 0.05 was considered statistically significant.
We analyzed 16 ALS and 26 SLS with an average age of 63.5 ± 10 years. Preoperative ankle-brachial index (ABI) was 1.0 ± 0.2 for ALS (on control examination: 1.12 ± 0.24) and 0.08 ± 0.18 for SLS (on control examination 0.94 ± 0.14) (p < 0.05). Limb salvage rate was 100% for ALS and 86.7% for SLS (overall 93.3%). Primary patency rate for SLS was 85%, for ALS rate of 100%, respectively (overall 92.5%). ALS reached an average of 13.1 ± 2.7 points (SLS 11.4 ± 2.8) on a numeric point scale.
Open surgery is therapy and prevention of acute ischaemia all in one, especially for asymptomatic patients and delivers good long-term results. Endovascular therapies offer an alternative but long-term results are pending. Open surgery should still be considered as a gold standard therapy.
腘动脉瘤(PAA)较为罕见。开放式手术修复有多种不同的手术技术。本研究展示了采用内侧入路(MA)进行开放式手术修复的单中心经验,并概述了有症状(SLS)和无症状(ALS)下肢之间的差异。
回顾性收集数据。调查期为1996年1月1日至2013年1月1日。患者在门诊部就诊,并接受了关于其生活质量的问卷调查。数据以平均值±标准差表示。数据分析采用Mann-Whitney检验和趋势Cochran-Armitage检验。采用Kaplan-Meier方法计算肢体挽救率。p<0.05被认为具有统计学意义。
我们分析了16例无症状患者和26例有症状患者,平均年龄为63.5±10岁。无症状患者术前踝肱指数(ABI)为1.0±0.2(对照检查时为1.12±0.24),有症状患者为0.08±0.18(对照检查时为0.94±0.14)(p<0.05)。无症状患者的肢体挽救率为100%,有症状患者为86.7%(总体为93.3%)。有症状患者的一期通畅率为85%,无症状患者为100%(总体为92.5%)。在数字评分量表上,无症状患者平均得分为13.1±2.7分(有症状患者为11.4±2.8分)。
开放手术兼具治疗和预防急性缺血的作用,尤其对于无症状患者,且能带来良好的长期效果。血管内治疗是一种替代方法,但长期效果尚待确定。开放手术仍应被视为金标准治疗方法。