A meta-analysis of safety and efficacy of endovascular aneurysm repair in aneurysm patients with severe angulated infrarenal neck
A growing number of abdominal aortic aneurysms with severe angulated neck anatomy is treated by endovascular means. However, contradictory early and late outcomes have been reported. Our review and outcome analysis attempted to evaluate the available literature and provide clinicians with a base for...
Gespeichert in:
| Veröffentlicht in: | PloS one 2022-02, Vol.17 (2), p.e0264327-e0264327 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e0264327 |
|---|---|
| container_issue | 2 |
| container_start_page | e0264327 |
| container_title | PloS one |
| container_volume | 17 |
| creator | Bernardini, Giulia Litterscheid, Sarah Torsello, Giovanni Battista Torsello, Giovanni Federico Beropoulis, Efthymios Özdemir-van Brunschot, Denise |
| description | A growing number of abdominal aortic aneurysms with severe angulated neck anatomy is treated by endovascular means. However, contradictory early and late outcomes have been reported. Our review and outcome analysis attempted to evaluate the available literature and provide clinicians with a base for clinical implementation and future research.
A systematic review of the literature was undertaken to identify the outcomes of endovascular aneurysm repair in patients with severe infrarenal neck angulation (SNA ≥ 60°) vs non-severe neck angulation (NSNA). Outcome measures included perioperative complications, type 1a endoleak, neck-related secondary procedures, stent graft migration, aneurysm rupture, increase (>5mm) in sac diameter, all-cause and aneurysm-related mortality (PROSPERO Nr.: CRD42021233253).
Six observational studies reporting on 5981 patients (1457 with SNA and 4524 with NSNA) with a weighted mean follow-up period of 1.8 years were included. EVAR in SNA compared with NSNA was associated with a higher rate of type 1a endoleak at 30 days (4.0% vs 1.8%; p< 0.00001), at 1 year (2.8% vs 1.9%; p |
| doi_str_mv | 10.1371/journal.pone.0264327 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_2632789067</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A694824580</galeid><doaj_id>oai_doaj_org_article_4ca8a1cf4d674b9eb1af9ce676d5df48</doaj_id><sourcerecordid>A694824580</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-fbdeca0812cee463e1597240515611c7c3c6a83c2cbd6cb6b8d1dfb9c03ac79c3</originalsourceid><addsrcrecordid>eNqNk01v1DAQhiMEomXhHyCIhITgsIu_4iQXpKriY6VKlfi6WhN7vOuSjRfbWdgj_xxvuy1d1APKIdHMM-_Y72SK4iklM8pr-ubCj2GAfrb2A84Ik4Kz-l5xTFvOppIRfv_W91HxKMYLQireSPmwOOIVI0yw-rj4fVKuMMEUstQ2ulh6W0awmLYlDKZEa50Gvd2FcTB-A1GPPYScxDFs46oMuAYXSjf8Da0hORxSLH-6tCwjbjBgzi5yYUKTURsgYG5YDqi_Py4eWOgjPtm_J8XX9---nH6cnp1_mJ-enE21bFma2s6gBtJQphGF5EirtmaCVLSSlOpacy2h4Zrpzkjdya4x1Niu1YSDrlvNJ8XzK91176PauxcVk9m3piWyzsT8ijAeLtQ6uBWErfLg1GXAh4WCkJzuUQkNDVBthZG16FrsKNhWo6ylqYwVTdZ6u-82dis0OvsRoD8QPcwMbqkWfqOapiYij2xSvNoLBP9jxJjUykWNfZ9t9uPluXkjWkp2537xD3r37fbUAvIF8hB87qt3oupEtqJhomp2bWd3UPkxuHI6_2rW5fhBweuDgswk_JUWMMao5p8__T97_u2QfXmLXSL0aRl9Pybnh3gIiitQBx9jQHtjMiVqtynXbqjdpqj9puSyZ7cHdFN0vRr8D57fEac</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2632789067</pqid></control><display><type>article</type><title>A meta-analysis of safety and efficacy of endovascular aneurysm repair in aneurysm patients with severe angulated infrarenal neck</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Public Library of Science (PLoS) Journals Open Access</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Bernardini, Giulia ; Litterscheid, Sarah ; Torsello, Giovanni Battista ; Torsello, Giovanni Federico ; Beropoulis, Efthymios ; Özdemir-van Brunschot, Denise</creator><contributor>Saratzis, Athanasios</contributor><creatorcontrib>Bernardini, Giulia ; Litterscheid, Sarah ; Torsello, Giovanni Battista ; Torsello, Giovanni Federico ; Beropoulis, Efthymios ; Özdemir-van Brunschot, Denise ; Saratzis, Athanasios</creatorcontrib><description><![CDATA[A growing number of abdominal aortic aneurysms with severe angulated neck anatomy is treated by endovascular means. However, contradictory early and late outcomes have been reported. Our review and outcome analysis attempted to evaluate the available literature and provide clinicians with a base for clinical implementation and future research.
A systematic review of the literature was undertaken to identify the outcomes of endovascular aneurysm repair in patients with severe infrarenal neck angulation (SNA ≥ 60°) vs non-severe neck angulation (NSNA). Outcome measures included perioperative complications, type 1a endoleak, neck-related secondary procedures, stent graft migration, aneurysm rupture, increase (>5mm) in sac diameter, all-cause and aneurysm-related mortality (PROSPERO Nr.: CRD42021233253).
Six observational studies reporting on 5981 patients (1457 with SNA and 4524 with NSNA) with a weighted mean follow-up period of 1.8 years were included. EVAR in SNA compared with NSNA was associated with a higher rate of type 1a endoleak at 30 days (4.0% vs 1.8%; p< 0.00001), at 1 year (2.8% vs 1.9%; p<0.03), at 2 years (4.9% vs 2.1%; p< 0.0002), at 3 years (5.6% vs 2.6%; p< 0.0001). The rate of neck-related secondary procedures was significantly higher at 1 year (6.6% vs 3.9%; p<0.05) and at 3 years (13.1% vs 9%; p<0.05). Graft migration, aneurysm sack increase, aneurysm rupture and all-cause mortality were not statistically different at mid-term.
The use of EVAR in severely angulated infrarenal aortic necks is associated with a high rate of early and mid-term complications. However, aortic related and all-causes mortality are not higher compared to patients with NSNA. Therefore, EVAR should be cautiously used in patients with SNA.]]></description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0264327</identifier><identifier>PMID: 35202427</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Abdominal aneurysm ; Aneurysms ; Aorta ; Aortic Aneurysm, Abdominal - mortality ; Aortic Aneurysm, Abdominal - pathology ; Aortic Aneurysm, Abdominal - surgery ; Aortic aneurysms ; Authorship ; Cardiovascular system ; Care and treatment ; Complications ; Demographics ; Diameters ; Endovascular Procedures - adverse effects ; Endovascular Procedures - mortality ; Endovascular stents ; Health risks ; Humans ; Implants ; Literature reviews ; Meta-analysis ; Migration ; Mortality ; Patient outcomes ; Patients ; Postoperative Complications ; Rupture ; Rupturing ; Surgery, Experimental ; Surgical research ; Treatment Outcome</subject><ispartof>PloS one, 2022-02, Vol.17 (2), p.e0264327-e0264327</ispartof><rights>COPYRIGHT 2022 Public Library of Science</rights><rights>2022 Bernardini et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 Bernardini et al 2022 Bernardini et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-fbdeca0812cee463e1597240515611c7c3c6a83c2cbd6cb6b8d1dfb9c03ac79c3</citedby><cites>FETCH-LOGICAL-c692t-fbdeca0812cee463e1597240515611c7c3c6a83c2cbd6cb6b8d1dfb9c03ac79c3</cites><orcidid>0000-0002-0317-8782 ; 0000-0002-8731-0954</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870420/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870420/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2929,23871,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35202427$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Saratzis, Athanasios</contributor><creatorcontrib>Bernardini, Giulia</creatorcontrib><creatorcontrib>Litterscheid, Sarah</creatorcontrib><creatorcontrib>Torsello, Giovanni Battista</creatorcontrib><creatorcontrib>Torsello, Giovanni Federico</creatorcontrib><creatorcontrib>Beropoulis, Efthymios</creatorcontrib><creatorcontrib>Özdemir-van Brunschot, Denise</creatorcontrib><title>A meta-analysis of safety and efficacy of endovascular aneurysm repair in aneurysm patients with severe angulated infrarenal neck</title><title>PloS one</title><addtitle>PLoS One</addtitle><description><![CDATA[A growing number of abdominal aortic aneurysms with severe angulated neck anatomy is treated by endovascular means. However, contradictory early and late outcomes have been reported. Our review and outcome analysis attempted to evaluate the available literature and provide clinicians with a base for clinical implementation and future research.
A systematic review of the literature was undertaken to identify the outcomes of endovascular aneurysm repair in patients with severe infrarenal neck angulation (SNA ≥ 60°) vs non-severe neck angulation (NSNA). Outcome measures included perioperative complications, type 1a endoleak, neck-related secondary procedures, stent graft migration, aneurysm rupture, increase (>5mm) in sac diameter, all-cause and aneurysm-related mortality (PROSPERO Nr.: CRD42021233253).
Six observational studies reporting on 5981 patients (1457 with SNA and 4524 with NSNA) with a weighted mean follow-up period of 1.8 years were included. EVAR in SNA compared with NSNA was associated with a higher rate of type 1a endoleak at 30 days (4.0% vs 1.8%; p< 0.00001), at 1 year (2.8% vs 1.9%; p<0.03), at 2 years (4.9% vs 2.1%; p< 0.0002), at 3 years (5.6% vs 2.6%; p< 0.0001). The rate of neck-related secondary procedures was significantly higher at 1 year (6.6% vs 3.9%; p<0.05) and at 3 years (13.1% vs 9%; p<0.05). Graft migration, aneurysm sack increase, aneurysm rupture and all-cause mortality were not statistically different at mid-term.
The use of EVAR in severely angulated infrarenal aortic necks is associated with a high rate of early and mid-term complications. However, aortic related and all-causes mortality are not higher compared to patients with NSNA. Therefore, EVAR should be cautiously used in patients with SNA.]]></description><subject>Abdominal aneurysm</subject><subject>Aneurysms</subject><subject>Aorta</subject><subject>Aortic Aneurysm, Abdominal - mortality</subject><subject>Aortic Aneurysm, Abdominal - pathology</subject><subject>Aortic Aneurysm, Abdominal - surgery</subject><subject>Aortic aneurysms</subject><subject>Authorship</subject><subject>Cardiovascular system</subject><subject>Care and treatment</subject><subject>Complications</subject><subject>Demographics</subject><subject>Diameters</subject><subject>Endovascular Procedures - adverse effects</subject><subject>Endovascular Procedures - mortality</subject><subject>Endovascular stents</subject><subject>Health risks</subject><subject>Humans</subject><subject>Implants</subject><subject>Literature reviews</subject><subject>Meta-analysis</subject><subject>Migration</subject><subject>Mortality</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Postoperative Complications</subject><subject>Rupture</subject><subject>Rupturing</subject><subject>Surgery, Experimental</subject><subject>Surgical research</subject><subject>Treatment Outcome</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk01v1DAQhiMEomXhHyCIhITgsIu_4iQXpKriY6VKlfi6WhN7vOuSjRfbWdgj_xxvuy1d1APKIdHMM-_Y72SK4iklM8pr-ubCj2GAfrb2A84Ik4Kz-l5xTFvOppIRfv_W91HxKMYLQireSPmwOOIVI0yw-rj4fVKuMMEUstQ2ulh6W0awmLYlDKZEa50Gvd2FcTB-A1GPPYScxDFs46oMuAYXSjf8Da0hORxSLH-6tCwjbjBgzi5yYUKTURsgYG5YDqi_Py4eWOgjPtm_J8XX9---nH6cnp1_mJ-enE21bFma2s6gBtJQphGF5EirtmaCVLSSlOpacy2h4Zrpzkjdya4x1Niu1YSDrlvNJ8XzK91176PauxcVk9m3piWyzsT8ijAeLtQ6uBWErfLg1GXAh4WCkJzuUQkNDVBthZG16FrsKNhWo6ylqYwVTdZ6u-82dis0OvsRoD8QPcwMbqkWfqOapiYij2xSvNoLBP9jxJjUykWNfZ9t9uPluXkjWkp2537xD3r37fbUAvIF8hB87qt3oupEtqJhomp2bWd3UPkxuHI6_2rW5fhBweuDgswk_JUWMMao5p8__T97_u2QfXmLXSL0aRl9Pybnh3gIiitQBx9jQHtjMiVqtynXbqjdpqj9puSyZ7cHdFN0vRr8D57fEac</recordid><startdate>20220224</startdate><enddate>20220224</enddate><creator>Bernardini, Giulia</creator><creator>Litterscheid, Sarah</creator><creator>Torsello, Giovanni Battista</creator><creator>Torsello, Giovanni Federico</creator><creator>Beropoulis, Efthymios</creator><creator>Özdemir-van Brunschot, Denise</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-0317-8782</orcidid><orcidid>https://orcid.org/0000-0002-8731-0954</orcidid></search><sort><creationdate>20220224</creationdate><title>A meta-analysis of safety and efficacy of endovascular aneurysm repair in aneurysm patients with severe angulated infrarenal neck</title><author>Bernardini, Giulia ; Litterscheid, Sarah ; Torsello, Giovanni Battista ; Torsello, Giovanni Federico ; Beropoulis, Efthymios ; Özdemir-van Brunschot, Denise</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-fbdeca0812cee463e1597240515611c7c3c6a83c2cbd6cb6b8d1dfb9c03ac79c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abdominal aneurysm</topic><topic>Aneurysms</topic><topic>Aorta</topic><topic>Aortic Aneurysm, Abdominal - mortality</topic><topic>Aortic Aneurysm, Abdominal - pathology</topic><topic>Aortic Aneurysm, Abdominal - surgery</topic><topic>Aortic aneurysms</topic><topic>Authorship</topic><topic>Cardiovascular system</topic><topic>Care and treatment</topic><topic>Complications</topic><topic>Demographics</topic><topic>Diameters</topic><topic>Endovascular Procedures - adverse effects</topic><topic>Endovascular Procedures - mortality</topic><topic>Endovascular stents</topic><topic>Health risks</topic><topic>Humans</topic><topic>Implants</topic><topic>Literature reviews</topic><topic>Meta-analysis</topic><topic>Migration</topic><topic>Mortality</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Postoperative Complications</topic><topic>Rupture</topic><topic>Rupturing</topic><topic>Surgery, Experimental</topic><topic>Surgical research</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bernardini, Giulia</creatorcontrib><creatorcontrib>Litterscheid, Sarah</creatorcontrib><creatorcontrib>Torsello, Giovanni Battista</creatorcontrib><creatorcontrib>Torsello, Giovanni Federico</creatorcontrib><creatorcontrib>Beropoulis, Efthymios</creatorcontrib><creatorcontrib>Özdemir-van Brunschot, Denise</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection (ProQuest)</collection><collection>Natural Science Collection (ProQuest)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bernardini, Giulia</au><au>Litterscheid, Sarah</au><au>Torsello, Giovanni Battista</au><au>Torsello, Giovanni Federico</au><au>Beropoulis, Efthymios</au><au>Özdemir-van Brunschot, Denise</au><au>Saratzis, Athanasios</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A meta-analysis of safety and efficacy of endovascular aneurysm repair in aneurysm patients with severe angulated infrarenal neck</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2022-02-24</date><risdate>2022</risdate><volume>17</volume><issue>2</issue><spage>e0264327</spage><epage>e0264327</epage><pages>e0264327-e0264327</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract><![CDATA[A growing number of abdominal aortic aneurysms with severe angulated neck anatomy is treated by endovascular means. However, contradictory early and late outcomes have been reported. Our review and outcome analysis attempted to evaluate the available literature and provide clinicians with a base for clinical implementation and future research.
A systematic review of the literature was undertaken to identify the outcomes of endovascular aneurysm repair in patients with severe infrarenal neck angulation (SNA ≥ 60°) vs non-severe neck angulation (NSNA). Outcome measures included perioperative complications, type 1a endoleak, neck-related secondary procedures, stent graft migration, aneurysm rupture, increase (>5mm) in sac diameter, all-cause and aneurysm-related mortality (PROSPERO Nr.: CRD42021233253).
Six observational studies reporting on 5981 patients (1457 with SNA and 4524 with NSNA) with a weighted mean follow-up period of 1.8 years were included. EVAR in SNA compared with NSNA was associated with a higher rate of type 1a endoleak at 30 days (4.0% vs 1.8%; p< 0.00001), at 1 year (2.8% vs 1.9%; p<0.03), at 2 years (4.9% vs 2.1%; p< 0.0002), at 3 years (5.6% vs 2.6%; p< 0.0001). The rate of neck-related secondary procedures was significantly higher at 1 year (6.6% vs 3.9%; p<0.05) and at 3 years (13.1% vs 9%; p<0.05). Graft migration, aneurysm sack increase, aneurysm rupture and all-cause mortality were not statistically different at mid-term.
The use of EVAR in severely angulated infrarenal aortic necks is associated with a high rate of early and mid-term complications. However, aortic related and all-causes mortality are not higher compared to patients with NSNA. Therefore, EVAR should be cautiously used in patients with SNA.]]></abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>35202427</pmid><doi>10.1371/journal.pone.0264327</doi><tpages>e0264327</tpages><orcidid>https://orcid.org/0000-0002-0317-8782</orcidid><orcidid>https://orcid.org/0000-0002-8731-0954</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2022-02, Vol.17 (2), p.e0264327-e0264327 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2632789067 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Abdominal aneurysm Aneurysms Aorta Aortic Aneurysm, Abdominal - mortality Aortic Aneurysm, Abdominal - pathology Aortic Aneurysm, Abdominal - surgery Aortic aneurysms Authorship Cardiovascular system Care and treatment Complications Demographics Diameters Endovascular Procedures - adverse effects Endovascular Procedures - mortality Endovascular stents Health risks Humans Implants Literature reviews Meta-analysis Migration Mortality Patient outcomes Patients Postoperative Complications Rupture Rupturing Surgery, Experimental Surgical research Treatment Outcome |
| title | A meta-analysis of safety and efficacy of endovascular aneurysm repair in aneurysm patients with severe angulated infrarenal neck |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-13T14%3A14%3A23IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20meta-analysis%20of%20safety%20and%20efficacy%20of%20endovascular%20aneurysm%20repair%20in%20aneurysm%20patients%20with%20severe%20angulated%20infrarenal%20neck&rft.jtitle=PloS%20one&rft.au=Bernardini,%20Giulia&rft.date=2022-02-24&rft.volume=17&rft.issue=2&rft.spage=e0264327&rft.epage=e0264327&rft.pages=e0264327-e0264327&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0264327&rft_dat=%3Cgale_plos_%3EA694824580%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2632789067&rft_id=info:pmid/35202427&rft_galeid=A694824580&rft_doaj_id=oai_doaj_org_article_4ca8a1cf4d674b9eb1af9ce676d5df48&rfr_iscdi=true |