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- W2037980835 abstract "There has been considerable debate over the indications for elective surgery in the management of popliteal aneurysms. Proponents of conservative treatment cite patients with asymptomatic aneurysms being followed up for several years without incurring any ischaemic problems. They also quote significant complication rates for reconstruction and that many of the patients will die, usually from coronary arteriosclerosis, before becoming symptomatic. ~4 Conversely, those surgeons favouring aggressive elective intervention stress the reduced outcome following emergency surger~ and the risk of ischaemic complications in up to 33% of those patients managed conservatively, s-z° More importantl~ up to 33% of patients with acute preoperative ischaemia may require amputation in spite of urgent revascularisation n, 22 Patients managed conservatively also feature 4 12 13 a higher mortality rate • than those undergoing elective ligation and reconstruction. More recently the role of intraarterial thrombolysis has been suggested as further evidence to back the call for conservative treatment of popliteal aneurysms. 3'~ Whilst encouraging success has been obtained using this approach, these are in relatively small numbers of patients, in centres where there are enthusiasts for the technique, so that close co-operation between ward staff, radiologist and surgeons allows close monitoring of the patients' progress, a scenario that cannot be assumed in every hospital. To be effective, the delivery catheter should be sited beyond the aneurysm itself, into the distal popliteal artery or tibio-peroneal trunk. Lysis should then be" @default.
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- W2037980835 date "1995-02-01" @default.
- W2037980835 modified "2023-09-30" @default.
- W2037980835 title "Popliteal aneurysms — The case for elective surgery “Don't wait too long … Norman Hertzer, 1986”" @default.
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- W2037980835 doi "https://doi.org/10.1016/s1078-5884(05)80079-6" @default.
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