Management of the infected arterial pseudoaneurysm secondary to groin injecting drug use and outcomes: a systematic review protocol
Introduction People who inject drugs are at risk of a range of injecting-related infections and injuries, which can threaten life and limb. In parallel to escalating rates of drug-related deaths seen in Scotland and the UK, there has also been an increase in hospital admissions for skin and soft tis...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/6/e070615.full |
| _version_ | 1797803110923501568 |
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| author | Andrew Radley David Strachan Faisel Khan Stuart Suttie Caitlin Sara MacLeod John Nagy |
| author_facet | Andrew Radley David Strachan Faisel Khan Stuart Suttie Caitlin Sara MacLeod John Nagy |
| author_sort | Andrew Radley |
| collection | DOAJ |
| description | Introduction People who inject drugs are at risk of a range of injecting-related infections and injuries, which can threaten life and limb. In parallel to escalating rates of drug-related deaths seen in Scotland and the UK, there has also been an increase in hospital admissions for skin and soft tissue infections related to injecting drug use. One such injecting complication is the infected arterial pseudoaneurysm, which risks rupture and life-threatening haemorrhage. Surgical management options for the infected arterial pseudoaneurysm secondary to groin injecting drug use remain contentious, with some advocates for ligation and debridement alone, whilst others promote acute arterial reconstruction (suture or patch repair, bypass or, more recently, endovascular stent-graft placement). Rates of major lower limb amputations related to surgical management for this pathology vary in the literature. This review aims to evaluate the outcomes of arterial ligation alone compared with arterial reconstruction, including open and endovascular options, for the infected arterial pseudoaneurysm secondary to groin injecting drug use.Methods and analysis The methods will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Three electronic databases will be searched and the resultant papers screened according to the study inclusion and exclusion criteria (detailed in the Population, Intervention, Comparison, Outcomes and Study design statement). Grey literature will be excluded. All papers at each stage will be screened by two independent authors, with disagreements arbitrated by a third. Papers will be subject to appropriate standardised quality assessments.Primary outcome Major lower limb amputation.Secondary outcomes Reintervention rate, rebleeding rate, development of chronic limb-threatening ischaemia 30-day mortality and claudication.Ethics and dissemination This is a systematic review based on previously conducted studies, therefore, no ethical approval is required. The results of this work will be published in a peer-reviewed journal and presented at relevant conferences.PROSPERO registration number CRD42022358209. |
| first_indexed | 2024-03-13T05:15:55Z |
| format | Article |
| id | doaj.art-37bc6284e508432085694d8e07581014 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-13T05:15:55Z |
| publishDate | 2023-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-37bc6284e508432085694d8e075810142023-06-15T21:00:07ZengBMJ Publishing GroupBMJ Open2044-60552023-06-0113610.1136/bmjopen-2022-070615Management of the infected arterial pseudoaneurysm secondary to groin injecting drug use and outcomes: a systematic review protocolAndrew Radley0David Strachan1Faisel Khan2Stuart Suttie3Caitlin Sara MacLeod4John Nagy5Division of Cardiovascular Medicines and Diabetes, Ninewells Hospital and Medical School, Dundee, UKDepartment of Community Health Sciences, St George`s Hospital Medical School, Cranmer Terrace, London SW17 0REFrom the Section of Vascular Medicine and Biology, University Department of Medicine (D.J.N., F.K., J.J.F.B.), and Department of Anaesthesia (D.B., G.A.M., M.M., J.B.), Ninewells Hospital and Medical School, Dundee, Scotland.Department of Vascular Surgery, Ninewells Hospital and Medical School, Dundee, UKDepartment of Vascular Surgery, NHS Tayside, Dundee, UKDepartment of Vascular Surgery, NHS Tayside, Dundee, UKIntroduction People who inject drugs are at risk of a range of injecting-related infections and injuries, which can threaten life and limb. In parallel to escalating rates of drug-related deaths seen in Scotland and the UK, there has also been an increase in hospital admissions for skin and soft tissue infections related to injecting drug use. One such injecting complication is the infected arterial pseudoaneurysm, which risks rupture and life-threatening haemorrhage. Surgical management options for the infected arterial pseudoaneurysm secondary to groin injecting drug use remain contentious, with some advocates for ligation and debridement alone, whilst others promote acute arterial reconstruction (suture or patch repair, bypass or, more recently, endovascular stent-graft placement). Rates of major lower limb amputations related to surgical management for this pathology vary in the literature. This review aims to evaluate the outcomes of arterial ligation alone compared with arterial reconstruction, including open and endovascular options, for the infected arterial pseudoaneurysm secondary to groin injecting drug use.Methods and analysis The methods will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Three electronic databases will be searched and the resultant papers screened according to the study inclusion and exclusion criteria (detailed in the Population, Intervention, Comparison, Outcomes and Study design statement). Grey literature will be excluded. All papers at each stage will be screened by two independent authors, with disagreements arbitrated by a third. Papers will be subject to appropriate standardised quality assessments.Primary outcome Major lower limb amputation.Secondary outcomes Reintervention rate, rebleeding rate, development of chronic limb-threatening ischaemia 30-day mortality and claudication.Ethics and dissemination This is a systematic review based on previously conducted studies, therefore, no ethical approval is required. The results of this work will be published in a peer-reviewed journal and presented at relevant conferences.PROSPERO registration number CRD42022358209.https://bmjopen.bmj.com/content/13/6/e070615.full |
| spellingShingle | Andrew Radley David Strachan Faisel Khan Stuart Suttie Caitlin Sara MacLeod John Nagy Management of the infected arterial pseudoaneurysm secondary to groin injecting drug use and outcomes: a systematic review protocol BMJ Open |
| title | Management of the infected arterial pseudoaneurysm secondary to groin injecting drug use and outcomes: a systematic review protocol |
| title_full | Management of the infected arterial pseudoaneurysm secondary to groin injecting drug use and outcomes: a systematic review protocol |
| title_fullStr | Management of the infected arterial pseudoaneurysm secondary to groin injecting drug use and outcomes: a systematic review protocol |
| title_full_unstemmed | Management of the infected arterial pseudoaneurysm secondary to groin injecting drug use and outcomes: a systematic review protocol |
| title_short | Management of the infected arterial pseudoaneurysm secondary to groin injecting drug use and outcomes: a systematic review protocol |
| title_sort | management of the infected arterial pseudoaneurysm secondary to groin injecting drug use and outcomes a systematic review protocol |
| url | https://bmjopen.bmj.com/content/13/6/e070615.full |
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