The long-term outcomes of open and endovascular repair for abdominal aortic aneurysm: A meta-analysis

被引:13
|
作者
Chen, Zuo-guan [1 ,2 ]
Tan, Shu-ping [1 ]
Diao, Yong-peng [1 ]
Wu, Zhi-yuan [1 ,2 ]
Miao, Yu-qing [1 ,2 ]
Li, Yong-jun [1 ,2 ]
机构
[1] Beijing Hosp, Natl Ctr Gerontol, Dept Vasc Surg, Beijing 100730, Peoples R China
[2] Chinese Acad Med Sci, Peking Union Med Coll, Beijing 100730, Peoples R China
关键词
Abdominal aortic aneurysm; Endovascular repair; Meta-analysis; Open surgery; EVAR TRIAL 1; SURVIVAL; MORTALITY;
D O I
10.1016/j.asjsur.2019.01.014
中图分类号
R61 [外科手术学];
学科分类号
摘要
To provide a meta-analysis of studies evaluating long-term all-cause mortality, aneurysm-related mortality and re-intervention after open or endovascular repair for abdominal aortic aneurysm. Electronic bibliographic sources were interrogated using a combination of free text and controlled vocabulary searches to identify studies comparing the long-term outcomes of open and endovascular repair for abdominal aortic aneurysm. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards. Fixed effect or random effects models were used. We retrieved 4 randomized controlled trials (RCTs; 2,783 patients), 7 nonrandomized trials (86,035 patients). The primary outcome was all-cause mortality. Heterogeneity was high and publication bias could not be excluded. Despite these limitations, the analysis showed that open and endovascular abdominal aortic aneurysm repair had similar all-cause mortality (OR 1.16, 95% CI, 0.89-1.51) over 5 years follow up, which was maintained after at least 10 years of follow-up (OR 0.87, 95% CI, 0.73-1.03). There was no significant difference in aneurysm-related mortality by 5 years or longer follow-up. A significantly lower proportion of patients undergoing open repair required reintervention (OR 0.38, 95% CI 0.24-0.64), which was maintained over 5 years of follow-up. There is no long-term survival difference between the patients who underwent open or endovascular aneurysm repair. There is significantly higher risk of reinterventions after endovascular aneurysm repair. (C) 2019 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V.
引用
收藏
页码:899 / 906
页数:8
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