Comparison of Efficacy of Endovascular Aneurysm Repair Versus Open Surgical Repair in Middle/High-Risk Patients With Abdominal Aortic Aneurysm

Zhang, Chang-Lie; Song, Zhihong; Wang, Fan

doi:10.1097/mjt.0000000000000289

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…Some 3061 articles were identified, of which 115 were selected and read in full. Eventually 53 studies fulfilled the inclusion criteria ( Fig . ).…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of long-term survival after elective endovascular or open repair of abdominal aortic aneurysm

Bulder

Bastiaannet

Hamming

et al. 2019

British Journal of Surgery

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Background: Endovascular aneurysm repair (EVAR) has become the preferred strategy for elective repair of abdominal aortic aneurysm (AAA) for many patients. However, the superiority of the endovascular procedure has recently been challenged by reports of impaired long-term survival in patients who underwent EVAR. A systematic review of long-term survival following AAA repair was therefore undertaken.Methods: A systematic review was performed according to PRISMA guidelines. Articles reporting shortand/or long-term mortality of EVAR and open surgical repair (OSR) of AAA were identified. Pooled overall survival estimates (hazard ratios (HRs) with corresponding 95 per cent c.i. for EVAR versus OSR) were calculated using a random-effects model. Possible confounding owing to age differences between patients receiving EVAR or OSR was addressed by estimating relative survival.Results: Some 53 studies were identified. The 30-day mortality rate was lower for EVAR compared with OSR: 1⋅16 (95 per cent c.i. 0⋅92 to 1⋅39) versus 3⋅27 (2⋅71 to 3⋅83) per cent. Long-term survival rates were similar for EVAR versus OSR (HRs 1⋅01, 1⋅00 and 0⋅98 for 3, 5 and 10 years respectively; P = 0⋅721, P = 0⋅912 and P = 0⋅777). Correction of age inequality by means of relative survival analysis showed equal long-term survival: 0⋅94, 0⋅91 and 0⋅76 at 3, 5 and 10 years for EVAR, and 0⋅96, 0⋅91 and 0⋅76 respectively for OSR.Conclusion: Long-term overall survival rates were similar for EVAR and OSR. Available data do not allow extension beyond the 10-year survival window or analysis of specific subgroups. Literature search and inclusion criteriaA systematic review of the literature between 1991 and 2018 was undertaken according to PRISMA guidelines 6 . Studies were identified using PubMed, Embase, Web of Science and Cochrane databases. Eligible studies included patients with an intact AAA treated by either EVAR or OSR. Studies that did not compare Publication biasFunnel plots for 30-day and 5-year survival did not show considerable asymmetry (Fig. S2, supporting information).

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“…Some 3061 articles were identified, of which 115 were selected and read in full. Eventually 53 studies fulfilled the inclusion criteria ( Fig . ).…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of long-term survival after elective endovascular or open repair of abdominal aortic aneurysm

Bulder

Bastiaannet

Hamming

et al. 2019

British Journal of Surgery

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Thoracic Endovascular Aortic Repair and Endovascular Aneurysm Repair Approaches for Managing Aortic Pathologies: A Retrospective Cohort Study

Aljabri,

Iqbal,

Alanezi

et al. 2024

JCM

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Background/Objectives: Since thoracic endovascular aortic repair (TEVAR) and endovascular aneurysm repair (EVAR) are increasingly utilized, examining their outcomes and safety in real-world scenarios is crucial. This study investigated the management and outcomes of TEVAR and EVAR as alternatives to traditional open surgical repair for managing aortic pathologies. Methods: This was a retrospective cohort study. We analyzed the data from 59 consecutive patients who underwent TEVAR or EVAR between 2015 and 2022 at a single tertiary care center. The primary outcome was survival, and secondary outcomes were complications assessment, including re-intervention and occurrence of endoleaks. Results: TEVAR accounted for 47.5% of cases (n = 28), while EVAR comprised 52.5% (n = 31). Patients were mostly 61–70 years old (23.7%) and male (91.5%). Surgery indications differed, with aneurysmal repair being the prevalent indication for EVAR (90.3%, n = 28) and trauma being the main indication for TEVAR (67.9%, n = 19). Regarding the primary outcome, 11 patients (18.6%) died for various reasons; of those, 2 patients (3.4%) were determined to have died from vascular-related issues. Most patients (81.4%, n = 48) did not experience intraoperative complications. The most common intraoperative complications were endoleaks and access failure, each affecting 5.1% (n = 3) of patients. Re-intervention was necessary in 16.9% (n = 10) of cases, with endoleaks being the major indication (60%). Emergency intervention was more frequent in the TEVAR group (p = 0.013), resulting in significantly longer hospitalization (p = 0.012). Conclusions: Despite limitations, our analysis indicates a good safety profile with high success rates and a low incidence of adverse health outcomes and mortality in TEVAR/EVAR procedures. Nevertheless, the results emphasize the ongoing concern of endograft leaks, necessitating re-interventions.

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Comparison of Efficacy of Endovascular Aneurysm Repair Versus Open Surgical Repair in Middle/High-Risk Patients With Abdominal Aortic Aneurysm

Cited by 2 publications

References 28 publications

Meta-analysis of long-term survival after elective endovascular or open repair of abdominal aortic aneurysm

Meta-analysis of long-term survival after elective endovascular or open repair of abdominal aortic aneurysm

Thoracic Endovascular Aortic Repair and Endovascular Aneurysm Repair Approaches for Managing Aortic Pathologies: A Retrospective Cohort Study

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