背景:目的:全膝关节置换术(TKA)后,pop动脉假性动脉瘤是一种罕见但严重的并发症,传统上采用开放式手术修复治疗。血管内支架置入术,虽然相对较新,提供了一种侵入性较小的有前途的替代方案,并且可以降低围手术期并发症的风险。
方法:进行了系统的文献综述,并确定了从开始到2022年7月的所有英文临床报告。手动审查参考文献以确定其他研究。人口统计,程序技术,使用STATA14.1提取并分析术后并发症和随访数据。此外,我们介绍了一例使用覆膜血管内支架治疗的pop假性动脉瘤患者。
结果:共14项研究(12例病例报告,2例病例系列;n=17)纳入审查。在所有情况下,都在the动脉病变上放置了支架移植物。在11例中的5例中,出现了动脉血栓,并采用了相邻的方法进行了治疗(即机械血栓切除术,球囊血管成形术,etc).所有病例均报告手术成功,无围手术期不良事件。支架在中位随访32周(四分位间距IQR:36)中保持专利。除一例外,所有患者都立即缓解了症状,并且恢复顺利。对于我们的案子,随访12个月时患者无症状,超声显示血管通畅。
结论:血管内支架置入术是治疗pop假性动脉瘤的一种安全有效的方法。未来的研究应该旨在评估这种微创技术的长期结果。
BACKGROUND: Popliteal artery pseudoaneurysms are a rare but serious complication following total knee arthroplasty that have been traditionally managed with open surgical repair. Endovascular stenting, while relatively new, offers a promising alternative that is less invasive and may reduce the risk of perioperative complications.
METHODS: A systematic literature review was conducted, and all clinical
reports in the English language from inception to July 2022 were identified. References were manually reviewed to identify additional studies. Demographics, procedural techniques, postprocedural complications, and followup data were extracted and analyzed using STATA 14.1. Additionally, we present a
case of a patient with a popliteal pseudoaneurysm treated with a covered endovascular stent.
RESULTS: A total of 14 studies (12
case reports, 2
case series; n = 17) were included for review. In all cases, a stent-graft was placed across the popliteal artery lesion. In 5 out of 11 cases, popliteal artery thrombus was present and treated with adjacent modalities (i.e., mechanical thrombectomy, balloon angioplasty, etc.). Procedure success was reported in all cases without perioperative adverse events. Stents remained patent over a median followup of 32 weeks (interquartile range: 36). In all but one
case, the patients experienced immediate symptom relief and had an uneventful recovery. For our
case, at the 12-month followup the patient was asymptomatic, and ultrasound demonstrated vessel patency.
CONCLUSIONS: Endovascular stenting is a safe and effective treatment for popliteal pseudoaneurysms. Future studies should be aimed at evaluating the long-term outcomes of such minimally invasive techniques.