Proportional meta-analysis of open surgery or fenestrated-endograft repair for post-dissection thoracoabdominal aneurysms
| Autor: | Gianfranco Varetto, Lorenzo Gibello, Pietro Rispoli, Edoardo Frola, Tania Peretti, Fabio Verzini, Luca Porro, Andrea Gattuso, Michele Boero |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Clinical Decision-Making 030204 cardiovascular system & hematology Respiratory complication Risk Assessment open surgery 03 medical and health sciences Aortic aneurysm Blood Vessel Prosthesis Implantation 0302 clinical medicine Postoperative Complications Risk Factors aortic aneurysm aortic dissection endovascular meta-analysis post dissection thoracoabdominal aneurysm thoracoabdominal medicine Humans cardiovascular diseases 030212 general & internal medicine Aged Aortic dissection Aged 80 and over Aortic Aneurysm Thoracic business.industry Open surgery Significant difference Endovascular Procedures Mean age medicine.disease Surgery Blood Vessel Prosthesis Treatment Outcome Meta-analysis Retreatment cardiovascular system Open repair Female Cardiology and Cardiovascular Medicine business |
| Popis: | To determine outcomes of postdissection thoracoabdominal aneurysms by either open or endovascular repair with fenestrated or branched endografts.A systematic review was conducted for open or endovascular repair of postdissection thoracoabdominal aneurysms, between January 2009 and February 2020. A meta-analysis was performed for postoperative complications and both early and late mortality and reinterventions.Fifteen noncomparative studies (eight endovascular repair and seven open repair) were suitable for meta-analysis. Overall, 1337 patients were included, 1068 in the open repair group (73% male; mean age 58 years) and 269 in the endovascular repair group (79% male; mean age 65 years). The 30-day mortality was 6% for open repair vs 3% for endovascular repair (P = .35), whereas the 30-day reintervention rate was 3% for open repair vs 1% for endovascular repair (P = .66). The only significant difference was reported for 30-day respiratory complication rate (30% open repair vs 2% endovascular repair; P .01). The incidence of spinal cord ischemia was 9% for open repair vs 8% for endovascular repair (P = .95). The mean follow-up was 44 months: 48 months (range, 10-72 months) after open repair and 17 months (range, 12-25 months) after endovascular repair (P .01). Late aortic reinterventions were more frequent after endovascular repair (11% vs 32%; P .001). The late overall mortality rate was 19% for open repair vs 7% for endovascular repair (P = .08), whereas aortic-related mortality was 7% for open repair vs 3% for endovascular repair (P = .22).In the absence of comparative studies, this meta-analysis showed that endovascular repair seems to be a viable alternative for patients unfit for open repair. |
| Databáze: | OpenAIRE |
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