The role of fEVAR, chEVAR and open repair in treatment of juxtarenal aneurysms: a systematic review
| Autor: | Aleksa Jovanović, Igor Koncar, Stefan Ducic |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment MEDLINE 030204 cardiovascular system & hematology Prosthesis Design Endovascular aneurysm repair Blood Vessel Prosthesis Implantation 03 medical and health sciences Aortic aneurysm Postoperative Complications 0302 clinical medicine Aneurysm Risk Factors Blood vessel prosthesis Humans Medicine business.industry General surgery Endovascular Procedures General Medicine medicine.disease Abdominal aortic aneurysm Blood Vessel Prosthesis 3. Good health Treatment Outcome Systematic review 030228 respiratory system Inclusion and exclusion criteria Surgery Cardiology and Cardiovascular Medicine business Aortic Aneurysm Abdominal |
| Zdroj: | The Journal of Cardiovascular Surgery. 61 |
| ISSN: | 1827-191X 0021-9509 |
| DOI: | 10.23736/s0021-9509.19.11187-1 |
| Popis: | Introduction Open repair (OR), fenestrated endovascular aneurysm repair (fEVAR) and endovascular exclusion using parallel graft (chEVAR) are complementary procedures used for treatment of juxtarenal abdominal aortic aneurysm (jrAAA). The aim of our study was to assess available literature and analyze dispersion of OR, fEVAR and chEVAR procedures among reported papers related to treatment of jrAAA. Evidence acquisition The PubMed database was systematically searched using predefined strategy and key words related to treatment of jrAAA on September 28th, 2019. Studies were assessed for eligibility using the inclusion and exclusion criteria with at least five patients treated with at least one of the procedures while systematic reviews, meta-analysis, reviews, comments, editorials and letters were excluded as well as studies without clear classification of the location of the aneurysm, studies not specifying the number of patients treated with each of the techniques or not discriminated between aortic pathologies (juxtarenal, paravisceral and thoracoabdominal), hybrid procedures, endoanchors or with branched stent-graft. Evidence synthesis Overall, 1533 papers were identified while papers that met inclusion criteria were either representing experience of single institution (87 papers) or from multicenter studies (6 papers), national or international registries (18 papers). In the period between January 1977 and December 2017, treatment of 5664 patients with jrAAA was reported in 87 papers as a single institution report. Out of them 2531 (45%) were treated with OR, 2592 (46%) with fEVAR and 541 (9%) with chEVAR. Out of 29 institutions reporting OR, there were 11 (37.9%) with more than 100 treated patients while 21 (41.1%) out of 51 institutions that reported more than 50 jrAAA treated with fEVAR. Only four institutions reported results of all three treatment modalities. Conclusions Based on the results reported in the literature, regardless of its complexity and costs, fEVAR for jrAAA has been accepted in substantial number of hospitals worldwide, while number of reported procedures is reaching OR. |
| Databáze: | OpenAIRE |
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