Abstract：
The aim of the present study was to assess the early and mid-term outcomes of open surgical repair (OSR) for popliteal artery aneurysms (PAAs) with prosthetic grafts.
The pre-, intra-, and postoperative data for all the patients who had undergone OSR for PAAs with prosthetic grafts at our Institution between January 2009 and July 2019 were included in a prospectively maintained database, which was retrospectively analyzed. Primary patency was defined as uninterrupted flow (<50% stenosis) in the graft with no additional procedures performed. Secondary patency was defined as the restoration of graft patency.
A total of 82 patients had undergone OSR for 104 PAAs (median age, 71 years; interquartile range [IQR], 67-78 years; 82 men) with prosthetic grafts. Of the 104 PAAs, 72 (68%) had been asymptomatic. The median diameter was 30 mm (IQR, 24-37 mm). A medial approach was used for 35 PAAs (34%) and a posterior approach for 69 (65%). The repairs consisted of aneurysmectomy or aneurysm ligation without removal with an interposition graft placed and end-to-end anastomoses. The median operative time was 120 minutes (IQR, 103-142 minutes). The estimated blood loss was 281 mL (IQR, 150-281 mL). Only one patient treated with a posterior approach sustained a permanent peroneal nerve lesion. A second patient also treated via the posterior approach had required surgical revision for bleeding on postoperative day 2. No temporary lesions were recorded. No early amputations were required, and no perioperative deaths occurred. The median length of stay was 3 days (IQR, 3-4 days). An expanded polytetrafluoroethylene graft was used in 92 cases (88%) and a Dacron graft in 12 cases (12%). An 8-mm graft was used in 64 cases (62%). The median follow-up was 34.6 months (IQR, 8.5-62.7 months). No related mortality occurred. Of the 104 PAAs, 19 had required reintervention, with primary and secondary patency of 78% and 88% at 3 years, respectively. The median interval to reintervention was 28.3 months.
OSR of PAAs with prosthetic grafts is safe and feasible, with good mid-term results and satisfactory primary and secondary patency at 3 years.
The pre-, intra-, and postoperative data for all the patients who had undergone OSR for PAAs with prosthetic grafts at our Institution between January 2009 and July 2019 were included in a prospectively maintained database, which was retrospectively analyzed. Primary patency was defined as uninterrupted flow (<50% stenosis) in the graft with no additional procedures performed. Secondary patency was defined as the restoration of graft patency.
A total of 82 patients had undergone OSR for 104 PAAs (median age, 71 years; interquartile range [IQR], 67-78 years; 82 men) with prosthetic grafts. Of the 104 PAAs, 72 (68%) had been asymptomatic. The median diameter was 30 mm (IQR, 24-37 mm). A medial approach was used for 35 PAAs (34%) and a posterior approach for 69 (65%). The repairs consisted of aneurysmectomy or aneurysm ligation without removal with an interposition graft placed and end-to-end anastomoses. The median operative time was 120 minutes (IQR, 103-142 minutes). The estimated blood loss was 281 mL (IQR, 150-281 mL). Only one patient treated with a posterior approach sustained a permanent peroneal nerve lesion. A second patient also treated via the posterior approach had required surgical revision for bleeding on postoperative day 2. No temporary lesions were recorded. No early amputations were required, and no perioperative deaths occurred. The median length of stay was 3 days (IQR, 3-4 days). An expanded polytetrafluoroethylene graft was used in 92 cases (88%) and a Dacron graft in 12 cases (12%). An 8-mm graft was used in 64 cases (62%). The median follow-up was 34.6 months (IQR, 8.5-62.7 months). No related mortality occurred. Of the 104 PAAs, 19 had required reintervention, with primary and secondary patency of 78% and 88% at 3 years, respectively. The median interval to reintervention was 28.3 months.
OSR of PAAs with prosthetic grafts is safe and feasible, with good mid-term results and satisfactory primary and secondary patency at 3 years.
摘要：
本研究的目的是评估假体移植物开放性手术修复（OSR）治疗the动脉动脉瘤（PAA）的早期和中期结果。
前，intra-,在2009年1月至2019年7月期间在我们的机构接受过OSR的PAA假体移植的所有患者的术后数据都包含在前瞻性维护的数据库中，对此进行了回顾性分析。原发通畅被定义为移植物中的不间断流动(<50%狭窄),不进行额外的手术。继发性通畅被定义为移植物通畅的恢复。
共有82例患者接受OSR治疗104PAA（中位年龄，71年；四分位数范围[IQR]，67-78岁；82名男性）有假体移植物。在104个PAA中，72（68％）无症状。中值直径为30毫米(IQR，24-37毫米）。内侧入路用于35PAA（34％），后路入路用于69（65％）。修复包括动脉瘤切除术或动脉瘤结扎，而不切除，并放置插入移植物和端到端吻合。中位手术时间为120分钟(IQR，103-142分钟）。估计失血量为281毫升(IQR，150-281毫升)。只有一名接受后路治疗的患者出现永久性腓骨神经损伤。同样通过后路治疗的第二名患者在术后第2天需要手术翻修出血。没有记录到暂时性病变。不需要早期截肢，无围手术期死亡病例。中位住院时间为3天(IQR，3-4天）。92例（88％）使用膨体聚四氟乙烯移植物，12例（12％）使用涤纶移植物。64例（62％）使用了8毫米移植物。中位随访时间为34.6个月(IQR，8.5-62.7个月）。无相关死亡发生。在104个PAA中，19人需要重新干预，主要和次要通畅率在3年分别为78%和88%，分别。再次干预的中位间隔为28.3个月。
带假体移植的PAA的OSR是安全可行的，中期效果良好，3年时一级和二级通畅性令人满意。
前，intra-,在2009年1月至2019年7月期间在我们的机构接受过OSR的PAA假体移植的所有患者的术后数据都包含在前瞻性维护的数据库中，对此进行了回顾性分析。原发通畅被定义为移植物中的不间断流动(<50%狭窄),不进行额外的手术。继发性通畅被定义为移植物通畅的恢复。
共有82例患者接受OSR治疗104PAA（中位年龄，71年；四分位数范围[IQR]，67-78岁；82名男性）有假体移植物。在104个PAA中，72（68％）无症状。中值直径为30毫米(IQR，24-37毫米）。内侧入路用于35PAA（34％），后路入路用于69（65％）。修复包括动脉瘤切除术或动脉瘤结扎，而不切除，并放置插入移植物和端到端吻合。中位手术时间为120分钟(IQR，103-142分钟）。估计失血量为281毫升(IQR，150-281毫升)。只有一名接受后路治疗的患者出现永久性腓骨神经损伤。同样通过后路治疗的第二名患者在术后第2天需要手术翻修出血。没有记录到暂时性病变。不需要早期截肢，无围手术期死亡病例。中位住院时间为3天(IQR，3-4天）。92例（88％）使用膨体聚四氟乙烯移植物，12例（12％）使用涤纶移植物。64例（62％）使用了8毫米移植物。中位随访时间为34.6个月(IQR，8.5-62.7个月）。无相关死亡发生。在104个PAA中，19人需要重新干预，主要和次要通畅率在3年分别为78%和88%，分别。再次干预的中位间隔为28.3个月。
带假体移植的PAA的OSR是安全可行的，中期效果良好，3年时一级和二级通畅性令人满意。
