METHODS: A systematic search of the PubMed, Embase, Web of Science, Scopus, and CINAHL databases for clinical trials, case series, and case reports investigating true arterial aneurysms of the hand, published over the past 10 years, was performed. The inclusion criterion was surgical excision of arterial aneurysm, followed by arterial revascularization or ligation. Studies addressing pseudoaneurysms, mycotic aneurysms, conservative treatment, or no treatment were excluded. Summary level data regarding study characteristics and outcomes of amputation, neurological symptoms, number of preoperative vascular imaging examinations, and length of hospital stay were extracted.
RESULTS: Thirty-nine studies comprising 48 patients (mean [±standard deviation] age, 41.1 ± 22 years [range 0.5-80 years]; 39 [81.25%] male) were included. Thirty (62.5%) patients underwent only 1 preoperative examination and traumatic etiology was observed in 52.1% (n = 25). The most prevalent intervention was aneurysm excision, followed by arterial revascularization (n = 35 [72.9%]), with no amputations. Neurological symptoms were present in 8 (16.6%) subjects, with no difference between the revascularization and arterial ligation groups (odds ratio 3.36 [95% confidence interval 0.37-30.5]). The mean length of hospital stay was 1.44 days (range 0-4 days), with no difference between revascularization and arterial ligation (odds ratio 2.5 (95% confidence interval 0.10-62.6)).
CONCLUSIONS: This review did not find amputation rate outcomes associated with either technique, although similar neurological outcomes were observed. Nevertheless, the retrieved data were limited to those ensuring the safety of both procedures.
方法:对PubMed的系统搜索,Embase,WebofScience,Scopus,和CINAHL临床试验数据库,案例系列,和病例报告调查手的真实动脉瘤,在过去的10年里,已执行。纳入标准为手术切除动脉瘤,然后动脉血运重建或结扎。关于假性动脉瘤的研究,霉菌性动脉瘤,保守治疗,或不排除任何治疗。关于截肢研究特征和结果的汇总数据,神经症状,术前血管成像检查的数量,并提取了住院时间。
结果:39项研究包括48名患者(平均[±SD]年龄,包括41.1±22岁[范围0.5-80岁];39名男性[81.25%])。30例(62.5%)患者仅接受了1次术前检查,其中52.1%(n=25)观察到创伤性病因。最普遍的干预是动脉瘤切除术,其次是动脉血运重建(n=35[72.9%]),没有截肢。8名(16.6%)受试者出现神经系统症状,血运重建组和动脉结扎组之间无差异(比值比[OR]3.36[95%置信区间(CI)0.37-30.5]).平均住院时间为1.44天(范围为0-4天),血运重建和动脉结扎之间无差异(OR2.5[95%CI0.10-62.6])。
结论:这篇综述没有发现与这两种技术相关的截肢率结局,尽管观察到类似的神经系统结局。然而,检索到的数据仅限于确保两种手术安全性的数据.