دورية أكاديمية
Outcomes of advanced EVAR versus open surgery in the management of complex abdominal aortic aneurysm repair: A systematic review and meta-analysis.
| العنوان: | Outcomes of advanced EVAR versus open surgery in the management of complex abdominal aortic aneurysm repair: A systematic review and meta-analysis. |
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| المؤلفون: | Krisna Pertiwi PF; Faculty of Medicine, Udayana University/Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia., Sudarma IW; Cardiothoracic and Vascular Surgery Division, Department of Surgery, Faculty of Medicine, Udayana University, Indonesia/Prof. Dr I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia., Prana Jagannatha GN; Faculty of Medicine, Udayana University/Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia., Kosasih AM; Faculty of Medicine, Udayana University/Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia., Dyah Yustika Dewi CI; Faculty of Medicine, Udayana University/Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia., Angga Wijaya IGA; Faculty of Medicine, Udayana University/Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia. |
| المصدر: | Asian cardiovascular & thoracic annals [Asian Cardiovasc Thorac Ann] 2024 Jun 17, pp. 2184923241262847. Date of Electronic Publication: 2024 Jun 17. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Sage Country of Publication: England NLM ID: 9503417 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1816-5370 (Electronic) Linking ISSN: 02184923 NLM ISO Abbreviation: Asian Cardiovasc Thorac Ann Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Feb. 2009- : London : Sage Original Publication: Chen Yuan, Republic of Singapore : Asia Pub. EXchange, |
| مستخلص: | Background: Open surgery is still acknowledged as the gold standard for complex abdominal aortic aneurysm (c-AAA). Recently, advanced-endovascular aortic aneurysm repair (EVAR) for c-AAA has been developed, but its effectiveness compared to open surgery is still unclear. Method: A systematic search was performed on the MEDLINE through PubMed and ScienceDirect databases. The search was aimed to investigate outcomes of both fenestrated- and chimney-EVAR (consider as advanced EVAR) compared to open surgery in c-AAA. Outcomes included postoperative complications, 30-day mortality, long-term mortality, and reintervention rate. Data were collected using the Mantel-Haenszel fixed effects model with relative risk (RR) as the effect size with 95% confidence interval (CI). Results: A total of 25 studies ( n = 12,845 patients) were included in our study. The results demonstrated that advanced-EVAR correlated with diminished postoperative complications (RR 0.53; 95% CI 0.49-0.57; p < 0.001) compared to open surgery. Advanced-EVAR was associated with lower 30-day mortality compared to open surgery (RR 0.66; 95% CI 0.53-0.82; p < 0.001). Subgroup analysis revealed that fenestrated-EVAR resulted in superior outcomes ( p < 0.001), whereas the chimney-EVAR subgroup did not show significant differences ( p = 0.79), compared to open surgery in terms of 30-day mortality. Unfortunately, advanced-EVAR was associated with a higher long-term mortality rate (RR 1.46; 95% CI 1.20-1.78; p < 0.001) and a higher reintervention rate (RR 1.26; 95% CI 1.01-1.59; p = 0.04) compared to open surgery. Conclusion: Advanced EVAR, especially fenestrated-EVAR, presented better short-term outcomes compared to open surgery; however, it failed to demonstrate superiority over open surgery in improving long-term outcomes. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| فهرسة مساهمة: | Keywords: Abdominal aortic aneurysm; endovascular aneurysm repair; fenestrated endovascular aneurysm repair; open aneurysm repair |
| تواريخ الأحداث: | Date Created: 20240618 Latest Revision: 20240618 |
| رمز التحديث: | 20240619 |
| DOI: | 10.1177/02184923241262847 |
| PMID: | 38887046 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1816-5370 |
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| DOI: | 10.1177/02184923241262847 |