Aneurysma der A. profunda femoris - Eine systematische Literaturanalyse

TY - JOUR

T1 - Aneurysma der A. profunda femoris - Eine systematische Literaturanalyse

AU - Tsilimparis, N

AU - Faber, E

AU - Zindler, K

AU - Mohammad, W

AU - Hanack, U

AU - Yousefi, S

AU - Rückert, R I

N1 - Georg Thieme Verlag KG Stuttgart · New York.

PY - 2012/10

Y1 - 2012/10

N2 - INTRODUCTION: True aneurysms of the deep femoral artery (APFA) are rare and are usually presented as case reports. Recommendations for diagnostics and therapy of APFAs are based on low-level evidence only. The purpose of this paper was to summarise the existing world experience with APFA.MATERIAL/METHODS: On the occasion of our own case a systematic review of the literature was performed for diagnostics and therapy for true APFA. Publications retrieved from PubMed, EMBASE, and the Cochrane Collaboration as well as by hand search from their references were reviewed.RESULTS: From 2002 onwards 25 papers on true APFAs were published in the English and German literature. Apart from two retrospective studies over a longer period of time these were exclusively case reports. A total of 55 true APFAs were reported in 47 patients with a mean age of 63 years. Therapeutic intervention was due to a rupture in 10 cases (18 %). The mean maximal diameter of APFA at presentation was 5.4 cm (2-18 cm). APFAs that were not ruptured presented frequently as a painful pulsatile mass in the groin and thigh. Therapeutic options for APFA included, apart from surgical resection with or without reconstruction of the deep femoral artery, the endovascular repair.DISCUSSION: Symptoms of swelling and pain in the presence of a mass at the proximal thigh should raise the suspicion of an APFA. Surgical therapy should be performed electively in APFAs with a diameter of more than 2 cm or in cases of rapid progression as well as in all symptomatic or ruptured cases. The endovascular approach should be considered as an alternative option in all cases.

AB - INTRODUCTION: True aneurysms of the deep femoral artery (APFA) are rare and are usually presented as case reports. Recommendations for diagnostics and therapy of APFAs are based on low-level evidence only. The purpose of this paper was to summarise the existing world experience with APFA.MATERIAL/METHODS: On the occasion of our own case a systematic review of the literature was performed for diagnostics and therapy for true APFA. Publications retrieved from PubMed, EMBASE, and the Cochrane Collaboration as well as by hand search from their references were reviewed.RESULTS: From 2002 onwards 25 papers on true APFAs were published in the English and German literature. Apart from two retrospective studies over a longer period of time these were exclusively case reports. A total of 55 true APFAs were reported in 47 patients with a mean age of 63 years. Therapeutic intervention was due to a rupture in 10 cases (18 %). The mean maximal diameter of APFA at presentation was 5.4 cm (2-18 cm). APFAs that were not ruptured presented frequently as a painful pulsatile mass in the groin and thigh. Therapeutic options for APFA included, apart from surgical resection with or without reconstruction of the deep femoral artery, the endovascular repair.DISCUSSION: Symptoms of swelling and pain in the presence of a mass at the proximal thigh should raise the suspicion of an APFA. Surgical therapy should be performed electively in APFAs with a diameter of more than 2 cm or in cases of rapid progression as well as in all symptomatic or ruptured cases. The endovascular approach should be considered as an alternative option in all cases.

KW - Aged

KW - Aged, 80 and over

KW - Aneurysm/diagnosis

KW - Aneurysm, Ruptured/surgery

KW - Angioplasty/methods

KW - Blood Vessel Prosthesis

KW - Child

KW - Diagnostic Imaging

KW - Embolization, Therapeutic/methods

KW - Femoral Artery/surgery

KW - Humans

KW - Leg/blood supply

KW - Middle Aged

KW - Prosthesis Design

KW - Retrospective Studies

KW - Sensitivity and Specificity

KW - Stents

U2 - 10.1055/s-0032-1327820

DO - 10.1055/s-0032-1327820

M3 - SCORING: Review

C2 - 23136103

VL - 137

SP - 430

EP - 435

JO - ZBL CHIR

JF - ZBL CHIR

SN - 0044-409X

IS - 5

ER -