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一项来自单一中心的五年回顾性研究:110例下肢股动脉和腘动脉瘤患者的位置、表现、诊断及治疗情况

A Five-Year Retrospective Study from a Single Center on the Location, Presentation, Diagnosis, and Management of 110 Patients with Aneurysms of the Femoral and Popliteal Arteries of the Lower Limb.

作者信息

Serafin Michał, Łyko-Morawska Dorota, Szostek Julia, Stańczyk Dariusz, Mąka Magdalena, Kania Iga, Kuczmik Wacław

机构信息

Department of General Surgery, Vascular Surgery, Angiology and Phlebology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 14 Medyków Street, 45-47 Ziołowa Street, 40-635 Katowice, Poland.

出版信息

J Clin Med. 2024 Jul 24;13(15):4323. doi: 10.3390/jcm13154323.

Abstract

Peripheral aneurysms, although known about for centuries, are challenging to monitor due to their asymptomatic nature. Advanced imaging has improved detection, which is crucial for preventing emergent complications. This five-year retrospective study from a single center aimed to evaluate the location, presentation, diagnosis, and management of 110 patients with aneurysms of the femoral and popliteal arteries of the lower limb. The study included 71 true aneurysms and 39 pseudoaneurysms patients treated between 2018-2023. Treatment methods were based on aneurysm size, atherosclerosis severity, and operation risk. The study assessed patient demographics, surgical details, postoperative complications, and aneurysm characteristics. Acute limb ischemia was more prevalent in true aneurysms (25.4% vs. 7.7%; = 0.02). Aneurysmectomy was performed more frequently in pseudoaneurysms (87.2% vs. 54.9%; < 0.001), while endovascular treatment and surgical bypass were more common in true aneurysms (Endovascular: 22.5% vs. 2.6%; = 0.01; bypass: 21.1% vs. 0%; < 0.001). Early postoperative complications occurred in 22.7% of patients. The 12-month freedom from reoperations (73.7% vs. 87%; = 0.07), amputations (97.7% vs. 93.8%; = 0.2), and graft stenosis (78.7% vs. 86.87%; = 0.06) showed no significant differences between groups. Lower limb aneurysms often present with non-specific symptoms, leading to late diagnosis and life-threatening complications. Both open and endovascular treatments are feasible, though more research is needed for pseudoaneurysms. Vigilant follow-up is crucial due to potential adverse events, though overall mortality and morbidity remain low.

摘要

外周动脉瘤虽然已被人们认识了几个世纪,但由于其无症状的特性,监测起来具有挑战性。先进的成像技术提高了检测能力,这对于预防紧急并发症至关重要。这项来自单一中心的五年回顾性研究旨在评估110例下肢股动脉和腘动脉瘤患者的病变位置、临床表现、诊断和治疗情况。该研究纳入了2018年至2023年间接受治疗的71例真性动脉瘤患者和39例假性动脉瘤患者。治疗方法基于动脉瘤大小、动脉粥样硬化严重程度和手术风险。该研究评估了患者的人口统计学特征、手术细节、术后并发症和动脉瘤特征。急性肢体缺血在真性动脉瘤中更为常见(25.4%对7.7%;P = 0.02)。假性动脉瘤更常进行动脉瘤切除术(87.2%对54.9%;P < 0.001),而血管内治疗和手术旁路在真性动脉瘤中更为常见(血管内治疗:22.5%对2.6%;P = 0.01;旁路:21.1%对0%;P < 0.001)。22.7%的患者出现早期术后并发症。两组在12个月时再次手术的无复发生存率(73.7%对87%;P = 0.07)、截肢率(97.7%对93.8%;P = 0.2)和移植物狭窄率(78.7%对86.87%;P = 0.06)方面无显著差异。下肢动脉瘤常表现为非特异性症状,导致诊断延迟和危及生命的并发症。开放手术和血管内治疗都是可行的,不过对于假性动脉瘤还需要更多研究。由于可能出现不良事件,进行密切随访至关重要,尽管总体死亡率和发病率仍然较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe0f/11312855/6b17fa3afae2/jcm-13-04323-g002.jpg

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