Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Treatment of Popliteal Aneurysm by Open and Endovascular Surgery: A Contemporary Study of 592 Procedures in Sweden
Uppsala University, Sweden; NU Hospital Org, Sweden.
Uppsala University, Sweden; NU Hospital Org, Sweden.
Uppsala University, Sweden; Lillebaelt Hospital, Denmark.
Malmö University Hospital, Sweden.
Visa övriga samt affilieringar
2015 (Engelska)Ingår i: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 50, nr 3, s. 342-350Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

WHAT THIS STUDY ADDS Previous comparisons between open and endovascular repair of popliteal aneurysms have focused on asymptomatic patients, and have short follow up. This study is strengthened by the fact that it is contemporary, population based, without any selection bias, reporting on all kinds of presentations, and has approximately 90% 1 year follow up data. It shows that endovascular repair has significantly inferior results compared with open repair, in particular in the group of patients who present with acute ischaemia. We believe these results will make many vascular surgeons think twice before they treat patients endovascularly in the future. Background: Popliteal aneurysm (PA) is traditionally treated by open repair (OR). Endovascular repair (ER) has become more common. The aim was to describe time trends and compare results (OR/ER). Methods: The Swedish vascular registry, Swedvasc, has a specific PA module. Data were collected (2008-2012) and supplemented with a specific protocol (response rate 99.1%). Data were compared with previously published data (1994-2002) from the same database. Results: The number of operations for PA was 15.7/million person-years (8.3 during 1994-2001). Of 592 interventions for PA (499 patients), 174 (29.4%) were treated for acute ischaemia, 13 (2.2%) for rupture, 105 (17.7%) for other symptoms, and 300 (50.7%) were asymptomatic (31.5% were treated for acute ischaemia, 1994-2002, p = .58). There were no differences in background characteristics between OR and ER in the acute ischaennia group. The symptomatic and asymptomatic groups treated with ER were older (p = .006, p less than .001). ER increased 3.6 fold (4.7% 1994-2002, 16.7% 2008-2012, p = .0001). Of those treated for acute ischaemia, a stent graft was used in 27 (16.4%). Secondary patency after ER was 70.4% at 30 days and 47.6% at 1 year, versus 93.1% and 86.8% after OR (p = .001, less than .001). The amputation rate at 30 days was 14.8% after ER, 3.7% after OR (p = .022), and 17.4% and 6.8% at 1 year (p = .098). A stent graft was used in 18.3% for asymptomatic PA. Secondary patency after ER was 94.5% at 30 days and 83.7% at 1 year, compared with 98.8% and 93.5% after OR (p = .043 and 0.026). OR was performed with vein graft in 87.6% (395/451), with better primary and secondary patency at 1 year than prosthetic grafts (p = .002 and less than .001), and with a posterior approach in 20.8% (121/581). Conclusions: The number of operations for PA doubled while the indications remained similar. ER patency was inferior to OR, especially after treatment for acute ischaemia, and the amputation risk tended to be higher, despite similar pre-operative characteristics. (C) 2015 The Authors. Published by Elsevier Ltd on behalf of European Society for Vascular Surgery. This is an open access article under the CC BY-NC-SA license (http://creativecommons.org/licenses/by-nc-sa/4.0/).

Ort, förlag, år, upplaga, sidor
W B SAUNDERS CO LTD , 2015. Vol. 50, nr 3, s. 342-350
Nyckelord [en]
Popliteal artery aneurysm; Open repair; Endovascular; Stent graft; Registry; Amputation
Nationell ämneskategori
Kirurgi
Identifikatorer
URN: urn:nbn:se:liu:diva-122118DOI: 10.1016/j.ejvs.2015.03.026ISI: 000361576800016PubMedID: 25911500OAI: oai:DiVA.org:liu-122118DiVA, id: diva2:861775
Anmärkning

Funding Agencies|Swedish Research Council [K2013-64X-20406-07-3]

Tillgänglig från: 2015-10-19 Skapad: 2015-10-19 Senast uppdaterad: 2017-12-01

Open Access i DiVA

fulltext(611 kB)117 nedladdningar
Filinformation
Filnamn FULLTEXT01.pdfFilstorlek 611 kBChecksumma SHA-512
e974235f4a0f6c84070bd6c505ddc1b542141ee538ae85e75403b17a8ab5805a0eea537c3457d7d313a5707046976cf6e16b13fa53b16b632120daad3254e00e
Typ fulltextMimetyp application/pdf

Övriga länkar

Förlagets fulltextPubMed

Sök vidare i DiVA

Av författaren/redaktören
Welander, Martin
Av organisationen
Avdelningen för kardiovaskulär medicinMedicinska fakulteten
I samma tidskrift
European Journal of Vascular and Endovascular Surgery
Kirurgi

Sök vidare utanför DiVA

GoogleGoogle Scholar
Totalt: 117 nedladdningar
Antalet nedladdningar är summan av nedladdningar för alla fulltexter. Det kan inkludera t.ex tidigare versioner som nu inte längre är tillgängliga.

doi
pubmed
urn-nbn

Altmetricpoäng

doi
pubmed
urn-nbn
Totalt: 144 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf