Effectiveness of endovascular repair versus open surgery for the treatment of thoracoabdominal aneurysm: A systematic review and meta analysis

Ellahi, Aayat; Shaikh, Faizan; Kashif, Haider; Khan, Hamna; Ali, Ehsan; Nasim, Bushra; Adil, Mariam; Huda, Zunera; Liaquat, Ayesha; Arshad, Muhammad Sameer

doi:10.1016/j.amsu.2022.104477

Cited by 8 publications

(2 citation statements)

References 27 publications

(28 reference statements)

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“…Postoperative dialysis was more frequent in the OR group (12.0% vs. 6.4%), but rates of permanent dialysis at discharge were similar (3.8% vs. 3.7%). A more recent meta-analysis found reduced mortality, cardiac, and respiratory complication rates in patients treated with F/BEVAR [108]. However, the type of treatment did not seem to influence the incidence of paraplegia.…”

Section: Clinical Outcomesmentioning

confidence: 97%

Comparison of Immediate, Medium, and Long-Term Postoperative Results of Open Surgery and Fenestrated/Branched Stent Grafts for Extended Thoracoabdominal Aortic Aneurysms

Cochennec,

Couture,

Chiche

2023

JCM

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The optimal surgical treatment for extended thoracoabdominal aortic aneurysms (TAAAs) is still a matter of debate. The historical treatment is open repair (OR), but over the past fifteen years, endovascular strategies have gained widespread acceptance. Although several endovascular techniques have been described for the treatment of TAAAs, fenestrated and branched stent grafts (F/BEVARs) are the most frequently used and best documented. They have become the first-line treatment for both high- and moderate-risk surgical patients in most vascular centers. However, no randomized study comparing OR and F/BEVAR has been published, and decision-making is mainly based on the physician’s preference and/or hospital expertise. The objective of this manuscript is to provide an overview of current comparative data for OR and F/BEVAR.

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Section: Clinical Outcomesmentioning

confidence: 97%

Comparison of Immediate, Medium, and Long-Term Postoperative Results of Open Surgery and Fenestrated/Branched Stent Grafts for Extended Thoracoabdominal Aortic Aneurysms

Cochennec,

Couture,

Chiche

2023

JCM

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“…Overall treatment for thoracoabdominal aneurysms (TAAA) has improved considerably over the past three decades because of advances in surgical techniques. Although open surgical repair remains popular, it has since been supplanted by total endovascular repair 1 , 2 . Unfortunately, these operations still carry significant risks of complications and mortality, with the potential of ischemic insult to the spinal cord, kidneys and other visceral organs 3 , 4 .…”

Section: Introductionmentioning

confidence: 99%

Haemodynamic changes in visceral hybrid repairs of type III and type V thoracoabdominal aortic aneurysms

Ong,

Wee,

Toma

et al. 2023

Sci Rep

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The visceral hybrid procedure combining retrograde visceral bypass grafting and completion endovascular stent grafting is a feasible alternative to conventional open surgical or wholly endovascular repairs of thoracoabdominal aneurysms (TAAA). However, the wide variability in visceral hybrid configurations means that a priori prediction of surgical outcome based on haemodynamic flow profiles such as velocity pattern and wall shear stress post repair remain challenging. We sought to appraise the clinical relevance of computational fluid dynamics (CFD) analyses in the setting of visceral hybrid TAAA repairs. Two patients, one with a type III and the other with a type V TAAA, underwent successful elective and emergency visceral hybrid repairs, respectively. Flow patterns and haemodynamic parameters were analysed using reconstructed pre- and post-operative CT scans. Both type III and type V TAAAs showed highly disturbed flow patterns with varying helicity values preoperatively within their respective aneurysms. Low time-averaged wall shear stress (TAWSS) and high endothelial cell action potential (ECAP) and relative residence time (RRT) associated with thrombogenic susceptibility was observed in the posterior aspect of both TAAAs preoperatively. Despite differing bypass configurations in the elective and emergency repairs, both treatment options appear to improve haemodynamic performance compared to preoperative study. However, we observed reduced TAWSS in the right iliac artery (portending a theoretical risk of future graft and possibly limb thrombosis), after the elective type III visceral hybrid repair, but not the emergency type V repair. We surmise that this difference may be attributed to the higher neo-bifurcation of the aortic stent graft in the type III as compared to the type V repair. Our results demonstrate that CFD can be used in complicated visceral hybrid repair to yield potentially actionable predictive insights with implications on surveillance and enhanced post-operative management, even in patients with complicated geometrical bypass configurations.

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Health Related Quality of Life Following Intervention for Thoracoabdominal Aortic Aneurysm: A Systematic Review and Narrative Synthesis

Lampridou,

Saghdaoui,

Bicknell

et al. 2024

Annals of Vascular Surgery

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Effectiveness of endovascular repair versus open surgery for the treatment of thoracoabdominal aneurysm: A systematic review and meta analysis

Cited by 8 publications

References 27 publications

Comparison of Immediate, Medium, and Long-Term Postoperative Results of Open Surgery and Fenestrated/Branched Stent Grafts for Extended Thoracoabdominal Aortic Aneurysms

Comparison of Immediate, Medium, and Long-Term Postoperative Results of Open Surgery and Fenestrated/Branched Stent Grafts for Extended Thoracoabdominal Aortic Aneurysms

Haemodynamic changes in visceral hybrid repairs of type III and type V thoracoabdominal aortic aneurysms

Health Related Quality of Life Following Intervention for Thoracoabdominal Aortic Aneurysm: A Systematic Review and Narrative Synthesis

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