Abstract：
Infective native aneurysms (INA) of the infrapopliteal arteries are rare and have previously been poorly described. This systematic review aims to provide an overview of the literature of this entity. Furthermore, two case reports of our own clinical experience are presented. PubMed, ScienceDirect, Cochrane, Ovid Embase, Ovid MEDLINE, and Web of Science were searched for articles on INAs of the infrapopliteal segment from January 1990 to September 2023. Article screening and selection were performed adhering to PRISMA guidelines. A total of 98 articles were screened and 20 were eligible for inclusion, of which all were case reports. In total, 22 patients with 28 infrapopliteal INAs were identified. The majority of INAs were located in the tibioperoneal trunk (n = 10, 36%) followed by the posterior tibial artery (n = 7, 25%). A current, or history of, infective endocarditis (IE) was described in 18 out of 22 patients (82%). Two patients died during hospitalization and one patient required a transfemoral amputation. A conservative antibiotic-only approach was chosen in three out of 28 INAs, two of which were the case reports described in this article; surgical or endovascular intervention was performed in 19 out of 28 aneurysms. No complications occurred in the conservative group, but one complication (transfemoral amputation) occurred in the interventional group. Infrapopliteal INA is a rare entity, and most described cases are precipitated by IE. Surgery or endovascular treatment might be indicated, but more research is warranted to define which patient would benefit and by what surgical approach.
摘要：
膝下动脉的感染性天然动脉瘤（INA）很少见，以前的描述很少。本系统综述旨在提供该实体文献的概述。此外，介绍了我们自己的临床经验的两个病例报告。PubMed,ScienceDirect,科克伦,OvidEmbase,OvidMEDLINE,从1990年1月至2023年9月，在WebofScience中搜索了有关INA的文章。根据PRISMA指南进行文章筛选和选择。共筛选了98篇文章,20篇符合入选条件,都是病例报告。总的来说,确定了22例患者的28个膝下INA。大多数INA位于胫腓骨干（n=10，36％），其次是胫后动脉（n=7，25％）。电流，或历史，22例患者中有18例(82%)描述了感染性心内膜炎(IE).两名患者在住院期间死亡，一名患者需要经股截肢。在28个INA中，有3个选择了仅使用抗生素的保守方法，其中2例是本文所述的病例报告;在28个动脉瘤中的19个进行了手术或血管内介入治疗.保守组无并发症发生,但介入组发生1例并发症(经股截肢)。皮下INA是一种罕见的实体，大多数描述的病例是由IE促成的。可能需要手术或血管内治疗，但有必要进行更多的研究来确定哪些患者将受益以及通过何种手术方法受益。
