Abstract：
BACKGROUND: Popliteal artery aneurysms (PAAs) are the most common peripheral aneurysm. However, due to its rarity, the cumulative body of evidence regarding patient patterns, treatment strategies, and perioperative outcomes is limited. This analysis aims to investigate distinct phenotypical patient profiles and associated treatment and outcomes in patients with a PAA by performing an unsupervised clustering analysis of the POPART (Practice of Popliteal Artery Aneurysm Repair and Therapy) registry.
RESULTS: A cluster analysis (using k-means clustering) was performed on data obtained from the multicenter POPART registry (42 centers from Germany and Luxembourg). Sensitivity analyses were conducted to explore validity and stability. Using 2 clusters, patients were primarily separated by the absence or presence of clinical symptoms. Within the cluster of symptomatic patients, the main difference between patients with acute limb ischemia presentation and nonemergency symptomatic patients was PAA diameter. When using 6 clusters, patients were primarily grouped by comorbidities, with patients with acute limb ischemia forming a separate cluster. Despite markedly different risk profiles, perioperative complication rates appeared to be positively associated with the proportion of emergency patients. However, clusters with a higher proportion of patients having any symptoms before treatment experienced a lower rate of perioperative complications.
CONCLUSIONS: The conducted analyses revealed both an insight to the public health reality of PAA care as well as patients with PAA at elevated risk for adverse outcomes. This analysis suggests that the preoperative clinic is a far more crucial adjunct to the patient\'s preoperative risk assessment than the patient\'s epidemiological profile by itself.
RESULTS: A cluster analysis (using k-means clustering) was performed on data obtained from the multicenter POPART registry (42 centers from Germany and Luxembourg). Sensitivity analyses were conducted to explore validity and stability. Using 2 clusters, patients were primarily separated by the absence or presence of clinical symptoms. Within the cluster of symptomatic patients, the main difference between patients with acute limb ischemia presentation and nonemergency symptomatic patients was PAA diameter. When using 6 clusters, patients were primarily grouped by comorbidities, with patients with acute limb ischemia forming a separate cluster. Despite markedly different risk profiles, perioperative complication rates appeared to be positively associated with the proportion of emergency patients. However, clusters with a higher proportion of patients having any symptoms before treatment experienced a lower rate of perioperative complications.
CONCLUSIONS: The conducted analyses revealed both an insight to the public health reality of PAA care as well as patients with PAA at elevated risk for adverse outcomes. This analysis suggests that the preoperative clinic is a far more crucial adjunct to the patient\'s preoperative risk assessment than the patient\'s epidemiological profile by itself.
摘要：
背景：p动脉动脉瘤（PAAs）是最常见的外周动脉瘤。然而,由于它的稀有性,关于病人模式的累积证据，治疗策略,围手术期结局有限。该分析旨在通过对POPART（pop动脉动脉瘤修复和治疗的实践）注册表进行无监督的聚类分析，调查PAA患者的独特表型患者概况以及相关治疗和结果。
结果：对从多中心POPART注册中心（来自德国和卢森堡的42个中心）获得的数据进行了聚类分析（使用k均值聚类）。进行敏感性分析以探讨有效性和稳定性。使用2个群集，患者主要因有无临床症状而分开.在有症状的患者群中，有急性肢体缺血表现的患者与非急诊有症状的患者之间的主要差异是PAA直径。当使用6个集群时，患者主要按合并症分组，与急性肢体缺血患者形成一个单独的集群。尽管风险状况明显不同，围手术期并发症发生率与急诊患者比例呈正相关.然而,治疗前出现任何症状的患者比例较高的集群围手术期并发症发生率较低.
结论：所进行的分析揭示了对PAA护理的公共卫生现实以及PAA患者不良结局风险升高的洞察力。此分析表明，术前诊所是患者术前风险评估的重要辅助手段，而不是患者本身的流行病学特征。
结果：对从多中心POPART注册中心（来自德国和卢森堡的42个中心）获得的数据进行了聚类分析（使用k均值聚类）。进行敏感性分析以探讨有效性和稳定性。使用2个群集，患者主要因有无临床症状而分开.在有症状的患者群中，有急性肢体缺血表现的患者与非急诊有症状的患者之间的主要差异是PAA直径。当使用6个集群时，患者主要按合并症分组，与急性肢体缺血患者形成一个单独的集群。尽管风险状况明显不同，围手术期并发症发生率与急诊患者比例呈正相关.然而,治疗前出现任何症状的患者比例较高的集群围手术期并发症发生率较低.
结论：所进行的分析揭示了对PAA护理的公共卫生现实以及PAA患者不良结局风险升高的洞察力。此分析表明，术前诊所是患者术前风险评估的重要辅助手段，而不是患者本身的流行病学特征。
