Professional paper - Review paper
Outcome of surgical and endovascular treatment of popliteal artery aneurysms

Roth, Aron; Oljača, Ana; Kovačević, Miljenko (2017)
Metadata
Language Croatian
Title (Croatian)Usporedba kirurškog i endovaskularnog liječenja aneurizmi poplitealnih arterija
Title (English)Outcome of surgical and endovascular treatment of popliteal artery aneurysms
AuthorRoth, Aron
Oljača, Ana
Kovačević, Miljenko
Abstract (Croatian)
Aneurizma poplitealne arterije lokalizirano je proširenje lumena poplitealne arterije koje najčešće nastaje kao posljedica ateroskleroze. Epidemiološka istraživanja pokazuju da su ovo najčešće aneurizme perifernih arterija s incidencijom od 0,1 do 2,8/100.000 ljudi koje uglavnom zahvaćaju mušku populaciju. U približno 50 % pacijenata aneurizme se nalaze bilateralno, a u 78 % slučajeva pacijenti ih imaju i na drugim arterijama, posebno na abdominalnoj aorti i ilijačnim krvnim žilama (64 %). U samom početku bolest je asimptomatska, a kasnije se može prezentirati bolovima, kompresijom, rijetko rupturom. Ako dođe do embolizacije tromba, koji potom distalno uzrokuje akutnu ishemiju ekstremiteta, očituje se plavim nožnim prstima, bljedilom, ulceracijama, gangrenom te u najgorem slučaju završava amputacijom uda. Osnova dijagnostike je višeslojna kompjutorska tomografija (MSCT) angiografija koja predstavlja zlatni standard, a ponekad je dovoljna i palpacija poplitealne jame iza koljenog zgloba. Temelj liječenja je operativni zahvat koji se sastoji od podvezivanja i isključivanja aneurizme iz krvotoka te formiranja i zaobilaženja aneurizme premosnicom. Druga opcija je endovaskularno liječenje, pri čemu se ugrađuje stent unutar aneurizme kako bi se ona isključila iz krvotoka. Prednosti ovog tipa zahvata su brz oporavak i kratko vrijeme hospitalizacije, a pogodna je u pacijenata s visokim operativnim rizikom. Ipak, veliki nedostaci su veća učestalost rane tromboze i začepljenja te veći broj komplikacija u odnosu na operativnu metodu. Operacija medijalnim pristupom najčešća je operativna metoda današnjice u liječenju aneurizmi poplitealnih arterija. Najbitnije prednosti su njeni odlični dugoročni rezultati, odsutnost komplikacija, jednostavnost i kratko trajanje zahvata, zbog čega predstavlja standard i prvu opciju kod liječenja aneurizmi poplitealnih arterija.
Abstract (English)
Popliteal artery aneurysm is a localized enlargement of lumen of popliteal artery due to atherosclerosis. With incidence of 0.1 – 2.8/100,000 people they are the most common aneurysms of peripheral arteries, affecting mostly male population. In about 50 % of patients aneurysms are found bilaterally and in 78 % of cases patients have them on other arteries, mostly (64 %) on abdominal aorta and iliac arteries. At the beginning, disease is asymptomatic and later it can be presented with pain, compression, rarely rupture and, if embolization of the thrombus occurs distal part of the limb will be ischemic, pale, with blue toes, ulcerations, gangrene and in worse case it will end with amputation. Diagnosis is based on multislice computed tomography (MSCT) angiography but sometimes even palpation of popliteal fossa behind knee articulation is enough. Surgical treatment consists of ligation and bypassing the aneurysm to exclude it from the blood flow. Other option is endovascular treatment in which stent is being embedded inside of the aneurism. The advantages of this treatment are quick recovery and short hospitalization and it is suitable for patients with high operative risk. However, big disadvantages are higher rate of early thrombosis and occlusion with greater number of complications compared with operative method. Operation by medial approach is nowadays the most common operative method in treatment of popliteal artery aneurisms. Most important advantages are great long-term results, low rate of complications, simplicity and short time of intervention which makes it a standard and a first option in treating popliteal artery aneurisms.
Keywords (Croatian)aneurizma ligatura poplitealna arterija stent tromboza
Keywords (English)aneurysm ligation popliteal artery stent thrombosis
Publication typeprofessional paper - review paper
Publication statuspublished
Peer reviewpeer review
Journal titleMedicina Fluminensis : Medicina Fluminensis
Numbering2017, Vol. 53, No. 2, pp 191-197
ISSN0025-7729
Datepublication: 01.06.2017.
DOI identifier10.21860/medflum2017_179761
Article URLhttp://hrcak.srce.hr/179761
Scientific fieldBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Surgery
InstitutionUniversity of Rijeka, Faculty of Medicine
(Department of Surgery)
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:184:087758