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Peripheral arterial aneurysms: open or endovascular surgery?
[thoracic outlet syndrome]
Peripheral
arterial
aneurysms
are
uncommon
;
for
some
aneurysm
types
,
data
are
limited
to
case
reports
and
small
case
series
.
There
is
no
Level
A
evidence
in
most
cases
to
determine
the
choice
between
open
or
endovascular
intervention
.
The
evolution
of
endovascular
technology
has
vastly
improved
the
armamentarium
available
to
the
vascular
surgeon
and
interventionalists
in
the
management
of
these
rare
and
unusual
aneurysms
.
The
choice
of
operative
approach
will
ultimately
be
determined
on
an
individual
basis
,
dependent
on
the
patient
risk
factors
,
and
aneurysm
anatomy
.
After
consideration
,
some
aneurysms
(
femoral
,
subclavian
,
carotid
and
ECAA
)
fare
better
with
an
open
first
approach
;
renal
,
splenic
and
some
visceral
artery
aneurysms
do
better
with
an
endovascular
first
approach
.
In
our
practice
PAAs
are
treated
with
an
endovascular
first
approach
.
For
these
rare
conditions
,
both
open
and
endovascular
therapy
will
continue
to
work
in
harmony
to
enhance
and
extend
the
capabilities
of
modern
surgical
management
.
Diseases
Validation
Diseases presenting
"open first approach"
symptom
thoracic outlet syndrome
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