Treatment Options for Buerger Disease: A Systematic Review and Meta-Analysis of Outcomes.

IF 1.8 3区医学 Q2 SURGERY

Journal of Surgical Research Pub Date : 2025-01-22 DOI:10.1016/j.jss.2024.12.034

Ramin Shekouhi, Mohammed Mumtaz, Humza Naqvi, Armina Azizi, Kristina M Crawford, Benjamin N Jacobs, Harvey Chim

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引用次数: 0

Abstract

Introduction: Uncertainties exist regarding the optimal management strategy for patients with thromboangiitis obliterans (TAOs). The aim of this study was to investigate the safety and effectiveness of common interventions used for treating patients with TAO.

Methods: Endovascular treatment, revascularization, sympathectomy, stem cell therapy (SCT), and nonsurgical interventions were selected for inclusion in the study. Changes in mean visual analogue scale score and ankle brachial index (ABI) values were evaluated. In addition, the rate of ulcer healing, postintervention amputation, and overall complication rates were compared across interventions.

Results: A total of 1262 TAO patients (1159 males, 84 females), with a mean age of 38.4 ± 7.8 ys, were included in this systematic review. With an amputation rate of 16.6%, the endovascular treatment group showed statistically significant improvements in mean ABI and visual analogue scale scores (P < 0.05). There was a greater increase in ABI postoperatively with endovascular treatment compared to SCT (P < 0.05), and also a greater increase in ABI postoperatively with revascularization compared to SCT (P < 0.05). Meta-regression showed that both endovascular treatment and open surgical revascularization were superior to stem cell treatment for postoperative mean ABI improvement (P < 0.05). Interestingly, the rate of postoperative amputation was lower in the SCT group compared with the other two interventions.

Conclusions: Our results indicated that all three interventions may be a reasonable therapeutic option for TAO. Endovascular intervention and open revascularization demonstrated superior outcomes.

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来源期刊

Journal of Surgical Research 医学-外科

CiteScore

3.90

自引率

4.50%

发文量

627

审稿时长

138 days

期刊介绍： The Journal of Surgical Research: Clinical and Laboratory Investigation publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. The journal emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers. The articles presented need not have been the products of surgeons or of surgical laboratories. The Journal of Surgical Research also features review articles and special articles relating to educational, research, or social issues of interest to the academic surgical community.