EFFECTIVENESS COMPARISON BETWEEN ENDOVASCULAR RECANALIZATION AND OPEN SURGICAL REVASCULARIZATION TO TREAT PERIPHERAL PSEUDOANEURYSM_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Kaizhen , REN Wei , CHENG Jun , ZHAO Yu.

Department of General Surgery, the First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, P.R.China. Corresponding author: REN Wei, E-mail: 626789849@qq.com;

Corresponding author：

Keywords：

Peripheral pseudoaneurysm; Endovascular recanalization; Open surgical revascularization

DOI：

10.7507/1002-1892.20130192

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Objective To compare the effectiveness, complications, and follow-up results between endovascular recanalization (EVR) and open surgical revascularization (OSR) in the treatment of peripheral pseudoaneurysm, so as to provide a reference for choosing a appropriate surgical procedure. Methods Clinical data of 62 cases of peripheral pseudoaneurysm between January 2001 and January 2012 were analyzed retrospectively. EVR was performed in 28 patients (EVR group) and OSR in 34 patients (OSR group). There was no significant difference in gender, age, cause of injury, tumor location, and diameter of tumor between 2 groups (P gt; 0.05). Results The operation time, blood loss, ICU monitoring time, and hospitalization time in EVR group were significantly shorter than those in OSR group (P lt; 0.05). In OSR group, 12 cases (35.29%) had early postoperative complications, including 2 deaths due to acute respiratory distress syndrome, 5 cases of pulmonary infection, 3 cases of wound infection, and 2 cases of deep vein thrombosis; in EVR group, 2 cases (7.14%) had early postoperative complications, including 1 case of hematoma at puncture site and 1 case of thrombosis in stent. There was significant difference in early postoperative complication incidence between 2 groups (χ2=6.691, P=0.008). The patients were followed up 12-39 months (mean, 26 months). In OSR and EVR groups after operation, the patency rates of the reconstructed vessels were 96.88% (31/32) and 92.86% (26/28) respectively at 12 months, showing no significant difference (χ2=0.014, P=0.905); the patency rates were 89.29% (25/28) and 84.00% (21/25) respectively at 24 months, showing no significant difference (χ2=0.322, P=0.570). Conclusion Compared with OSR, EVR is a minimally invasive, safe, and effective therapy for peripheral pseudoaneurysm with the advantages of less bleeding, shorter hospitalization time, and less complications. Long-term effectiveness still needs further observation, and patients have to take antiplatelet drugs for long time after EVR.

Citation： WANG Kaizhen,REN Wei,CHENG Jun,ZHAO Yu.. EFFECTIVENESS COMPARISON BETWEEN ENDOVASCULAR RECANALIZATION AND OPEN SURGICAL REVASCULARIZATION TO TREAT PERIPHERAL PSEUDOANEURYSM. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(7): 876-880. doi: 10.7507/1002-1892.20130192 Copy

1.	Wolosker N, Oba CM, Espirito Santo FR, et al. Endovascular treatment for chronic arteriovenous fistula between renal artery and inferior vena cava: image in vascular surgery. Vasc Endovascular Surg, 2010, 44(6): 489-490.
2.	Halvorson JJ, Anz A, Langfitt M, et al. Vascular injury associated with extremity trauma: initial diagnosis and management. J Am Acad Orthop Surg, 2011, 19(8): 495-504.
3.	Puech-Leão P, Wolosker N, Zerati AE, et al. Impact of endovascular technique in vascular surgery training at a large university hospital in Brazil. J Surg Educ, 2011, 68(1): 19-23.
4.	Wolosker N, Mendes Cde A, Jacob CE, et al. Endovascular infrarenal aortic aneurysm repair combined with laparoscopic cholecystectomy. Clinics (Sao Paulo), 2010, 65(7): 743-744.
5.	宋超, 陆清声, 洪毅, 等. 开放手术及腔内隔绝术治疗内脏动脉瘤对照研究. 中华普通外科杂志, 2012, 27(7): 543-545.
6.	du Toit DF, Coolen D, Lambrechts A, et al. The endovascular management of penetrating carotid artery injuries: long-term follow-up. Eur J Vasc Endovasc Surg, 2009, 38(3): 267-272.
7.	Ferreira J, Canedo A, Brandão D, et al. Isolated iliac artery aneurysms: six-year experience. Interact Cardiovasc Thorac Surg, 2010, 10(2): 245-248.
8.	DuBose JJ, Rajani R, Gilani R, et al. Endovascular management of axillo-subclavian arterial injury: a review of published experience. Injury, 2012, 43(11): 1785-1792.
9.	Reed AB. Advances in the endovascular management of acute injury. Perspect Vasc Surg Endovasc Ther, 2011, 23(1): 58-63.
10.	Papazoglou KO, Sfyroeras GS, Zambas N, et al. Outcomes of endovascular aneurysm repair with selective internal iliac artery cover age without coil embolization. J Vasc Surg, 2012, 56(2): 298-303.
11.	Garg K, Rockman CB, Kim BJ, et al. Outcome of endovascular repair of popliteal artery aneurysm using the Viabahn endoprosthesis. J Vasc Surg, 2012, 55(6): 1647-1653.
12.	Ruffino MA, Rabbia C, Italian Cardiatis Registry Investigators Group. Endovascular treatment of visceral aneurysms with Cardiatis multilayer flow modulator: preliminary results at six-months follow up. J Cardiovasc Surg (Torino), 2011, 52(3): 311-322.
13.	Danetz JS, Cassano AD, Stone MC, et al. Feasibility of endovascular repair in penetrating axillosubclavian injuries: a retrospective review. J Vase Surg, 2005, 41(2): 246-254.
14.	Patel NV, Long GW, Cheema ZF, et al. Open vs. endovascular repair of isolated iliac artery aneurysms: a 12-year experience. J Vasc Surg, 2009, 49(5): 1147-1153.
15.	Pitoulias GA, Donas KP, Schulte S, et al. Isolated iliac artery aneurysms: endovascular versus open elective repair. J Vasc Surg, 2007, 46(4): 648-654.
16.	Starnes BW, Arthurs ZM. Endovascular management of vascular trauma. Perspect Vasc Surg Endovasc Ther, 2006, 18(2): 114-129.
17.	White PW, Gillespie DL, Feurstein I, et al. Sixty-four slice multidetector computed tomographic angiography in the evaluation of vascular trauma. J Trauma, 2010, 68(1): 96-102.
18.	Cinà CS, Moore R, Maggisano R, et al. Endovascular repair of popliteal artery aneurysms with Anaconda limbs: technique and early results. Catheter Cardiovasc Interv, 2008, 72(5): 716-724.
19.	Tielliu IF, Zeebregts CJ, Vourliotakis G, et al. Stent fractures in the Hemobahn /Viabahn stent graft after endovascular popliteal aneurysm repair. J Vasc Surg, 2010, 51(6): 1413-1418.

1. Wolosker N, Oba CM, Espirito Santo FR, et al. Endovascular treatment for chronic arteriovenous fistula between renal artery and inferior vena cava: image in vascular surgery. Vasc Endovascular Surg, 2010, 44(6): 489-490.
2. Halvorson JJ, Anz A, Langfitt M, et al. Vascular injury associated with extremity trauma: initial diagnosis and management. J Am Acad Orthop Surg, 2011, 19(8): 495-504.
3. Puech-Leão P, Wolosker N, Zerati AE, et al. Impact of endovascular technique in vascular surgery training at a large university hospital in Brazil. J Surg Educ, 2011, 68(1): 19-23.
4. Wolosker N, Mendes Cde A, Jacob CE, et al. Endovascular infrarenal aortic aneurysm repair combined with laparoscopic cholecystectomy. Clinics (Sao Paulo), 2010, 65(7): 743-744.
5. 宋超, 陆清声, 洪毅, 等. 开放手术及腔内隔绝术治疗内脏动脉瘤对照研究. 中华普通外科杂志, 2012, 27(7): 543-545.
6. du Toit DF, Coolen D, Lambrechts A, et al. The endovascular management of penetrating carotid artery injuries: long-term follow-up. Eur J Vasc Endovasc Surg, 2009, 38(3): 267-272.
7. Ferreira J, Canedo A, Brandão D, et al. Isolated iliac artery aneurysms: six-year experience. Interact Cardiovasc Thorac Surg, 2010, 10(2): 245-248.
8. DuBose JJ, Rajani R, Gilani R, et al. Endovascular management of axillo-subclavian arterial injury: a review of published experience. Injury, 2012, 43(11): 1785-1792.
9. Reed AB. Advances in the endovascular management of acute injury. Perspect Vasc Surg Endovasc Ther, 2011, 23(1): 58-63.
10. Papazoglou KO, Sfyroeras GS, Zambas N, et al. Outcomes of endovascular aneurysm repair with selective internal iliac artery cover age without coil embolization. J Vasc Surg, 2012, 56(2): 298-303.
11. Garg K, Rockman CB, Kim BJ, et al. Outcome of endovascular repair of popliteal artery aneurysm using the Viabahn endoprosthesis. J Vasc Surg, 2012, 55(6): 1647-1653.
12. Ruffino MA, Rabbia C, Italian Cardiatis Registry Investigators Group. Endovascular treatment of visceral aneurysms with Cardiatis multilayer flow modulator: preliminary results at six-months follow up. J Cardiovasc Surg (Torino), 2011, 52(3): 311-322.
13. Danetz JS, Cassano AD, Stone MC, et al. Feasibility of endovascular repair in penetrating axillosubclavian injuries: a retrospective review. J Vase Surg, 2005, 41(2): 246-254.
14. Patel NV, Long GW, Cheema ZF, et al. Open vs. endovascular repair of isolated iliac artery aneurysms: a 12-year experience. J Vasc Surg, 2009, 49(5): 1147-1153.
15. Pitoulias GA, Donas KP, Schulte S, et al. Isolated iliac artery aneurysms: endovascular versus open elective repair. J Vasc Surg, 2007, 46(4): 648-654.
16. Starnes BW, Arthurs ZM. Endovascular management of vascular trauma. Perspect Vasc Surg Endovasc Ther, 2006, 18(2): 114-129.
17. White PW, Gillespie DL, Feurstein I, et al. Sixty-four slice multidetector computed tomographic angiography in the evaluation of vascular trauma. J Trauma, 2010, 68(1): 96-102.
18. Cinà CS, Moore R, Maggisano R, et al. Endovascular repair of popliteal artery aneurysms with Anaconda limbs: technique and early results. Catheter Cardiovasc Interv, 2008, 72(5): 716-724.
19. Tielliu IF, Zeebregts CJ, Vourliotakis G, et al. Stent fractures in the Hemobahn /Viabahn stent graft after endovascular popliteal aneurysm repair. J Vasc Surg, 2010, 51(6): 1413-1418.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS COMPARISON BETWEEN ENDOVASCULAR RECANALIZATION AND OPEN SURGICAL REVASCULARIZATION TO TREAT PERIPHERAL PSEUDOANEURYSM

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