Endoleak after stent-graft treatment of abdominal aortic aneurysm: a meta-analysis of clinical studies
Background: Endoleak is the major complication after endovascular treatment of abdominal aortic aneurysm (AAA) and its incidence seems to remain significant. Little is known about the association of device type and configuration with respect to the incidence, location, time of onset and fate of endo...
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Veröffentlicht in: | British journal of surgery 1999-05, Vol.86 (5), p.581-587 |
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description | Background:
Endoleak is the major complication after endovascular treatment of abdominal aortic aneurysm (AAA) and its incidence seems to remain significant. Little is known about the association of device type and configuration with respect to the incidence, location, time of onset and fate of endoleakage.
Methods:
A meta‐analysis was performed via a Medline search of clinical studies after 1995 dealing with the endovascular treatment of AAA. Details of number of patients treated, configuration and type of endovascular device were collected. Data concerning site of origin, time of occurrence and fate of the endoleak were retrieved, along with information on change in diameter of the aneurysm with time.
Results:
The 23 publications included reported on 1189 patients. The 1118 patients with successfully inserted transfemoral endovascular grafts experienced 270 endoleaks (24 per cent). The majority arose from the distal stent attachment site (36 per cent), were present immediately after stent‐graft placement (66 per cent) and were persistent in time (37 per cent). Tube grafts were more frequently affected by endoleakage (35 per cent; P < 0·0001), especially at the distal stent attachment site (51 per cent), than bifurcated grafts (18 per cent; P = 0·004) and aortounilateral devices (20 per cent; P = 0·70). Self‐ expandable stent‐grafts were more frequently associated with endoleaks (25 per cent) than balloon‐expandable stent‐grafts (17 per cent) (P = 0·037).
Conclusion:
Endovascular treatment of AAA is an evolving field. Even after the initial learning curve and attention to device‐related problems, it is still accompanied by a significant number of endoleaks. Uniform presentation of results of treatment is necessary for analysing the effect of differences between patients, aneurysm morphology and device type. © 1999 British Journal of Surgery Society Ltd |
doi_str_mv | 10.1046/j.1365-2168.1999.01119.x |
format | Article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_69810781</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>69810781</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4480-e0435b6f3ed1f4277fb58535e5b641164db51dc25d100d8f72f212a730368d883</originalsourceid><addsrcrecordid>eNpNkd9vFCEQgInR2Ovpv2B4ML7tysAusMYXr2mrTVNjrNE3wi5guO6PCmy8--9lvbP2iQzzzcDMhxAGUgKp-NttCYzXBQUuS2iapiQA0JS7J2j1kHiKVoQQUQCj7ASdxrglBBip6XN0AoRxAMFWyJ2PZuqtvsPaJRtwTHZMxc-QI5yC1WnIMZ4c1q2ZBj_qHuspJN9hPdo57OPwDms82KQLnZP76ONCd70ffZfhmGbjbXyBnjndR_vyeK7Rt4vz27OPxfXny09nH66LrqokKSypWN1yx6wBV1EhXFvLmtU2X1YAvDJtDaajtQFCjHSCOgpUC5bnkUZKtkZvDn3vw_RrtjGpwcfO9n3-7TRHxRsJREjI4KsjOLeDNeo--EGHvfq3mQy8PgI65kFc0GPn439ONJxXPGPvD9hv39v9ozZqEaW2avGhFh9qEaX-ilI7tbn6SvNba1Qcyn1e_O6hXIc7xQUTtfp-c6luf9CrL3KzUYz9AZN2lPw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>69810781</pqid></control><display><type>article</type><title>Endoleak after stent-graft treatment of abdominal aortic aneurysm: a meta-analysis of clinical studies</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>Oxford University Press Journals All Titles (1996-Current)</source><creator>Schurink, G. W. H. ; Aarts, N. J. M. ; van Bockel, J. H.</creator><creatorcontrib>Schurink, G. W. H. ; Aarts, N. J. M. ; van Bockel, J. H.</creatorcontrib><description>Background:
Endoleak is the major complication after endovascular treatment of abdominal aortic aneurysm (AAA) and its incidence seems to remain significant. Little is known about the association of device type and configuration with respect to the incidence, location, time of onset and fate of endoleakage.
Methods:
A meta‐analysis was performed via a Medline search of clinical studies after 1995 dealing with the endovascular treatment of AAA. Details of number of patients treated, configuration and type of endovascular device were collected. Data concerning site of origin, time of occurrence and fate of the endoleak were retrieved, along with information on change in diameter of the aneurysm with time.
Results:
The 23 publications included reported on 1189 patients. The 1118 patients with successfully inserted transfemoral endovascular grafts experienced 270 endoleaks (24 per cent). The majority arose from the distal stent attachment site (36 per cent), were present immediately after stent‐graft placement (66 per cent) and were persistent in time (37 per cent). Tube grafts were more frequently affected by endoleakage (35 per cent; P < 0·0001), especially at the distal stent attachment site (51 per cent), than bifurcated grafts (18 per cent; P = 0·004) and aortounilateral devices (20 per cent; P = 0·70). Self‐ expandable stent‐grafts were more frequently associated with endoleaks (25 per cent) than balloon‐expandable stent‐grafts (17 per cent) (P = 0·037).
Conclusion:
Endovascular treatment of AAA is an evolving field. Even after the initial learning curve and attention to device‐related problems, it is still accompanied by a significant number of endoleaks. Uniform presentation of results of treatment is necessary for analysing the effect of differences between patients, aneurysm morphology and device type. © 1999 British Journal of Surgery Society Ltd</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1046/j.1365-2168.1999.01119.x</identifier><identifier>PMID: 10361173</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject>Aortic Aneurysm, Abdominal - surgery ; Biological and medical sciences ; Blood Vessel Prosthesis ; Humans ; Medical sciences ; Randomized Controlled Trials as Topic ; Stents ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgical Wound Dehiscence - etiology ; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</subject><ispartof>British journal of surgery, 1999-05, Vol.86 (5), p.581-587</ispartof><rights>1999 British Journal of Surgery Society Ltd</rights><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4480-e0435b6f3ed1f4277fb58535e5b641164db51dc25d100d8f72f212a730368d883</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1046%2Fj.1365-2168.1999.01119.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1046%2Fj.1365-2168.1999.01119.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1796646$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10361173$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schurink, G. W. H.</creatorcontrib><creatorcontrib>Aarts, N. J. M.</creatorcontrib><creatorcontrib>van Bockel, J. H.</creatorcontrib><title>Endoleak after stent-graft treatment of abdominal aortic aneurysm: a meta-analysis of clinical studies</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background:
Endoleak is the major complication after endovascular treatment of abdominal aortic aneurysm (AAA) and its incidence seems to remain significant. Little is known about the association of device type and configuration with respect to the incidence, location, time of onset and fate of endoleakage.
Methods:
A meta‐analysis was performed via a Medline search of clinical studies after 1995 dealing with the endovascular treatment of AAA. Details of number of patients treated, configuration and type of endovascular device were collected. Data concerning site of origin, time of occurrence and fate of the endoleak were retrieved, along with information on change in diameter of the aneurysm with time.
Results:
The 23 publications included reported on 1189 patients. The 1118 patients with successfully inserted transfemoral endovascular grafts experienced 270 endoleaks (24 per cent). The majority arose from the distal stent attachment site (36 per cent), were present immediately after stent‐graft placement (66 per cent) and were persistent in time (37 per cent). Tube grafts were more frequently affected by endoleakage (35 per cent; P < 0·0001), especially at the distal stent attachment site (51 per cent), than bifurcated grafts (18 per cent; P = 0·004) and aortounilateral devices (20 per cent; P = 0·70). Self‐ expandable stent‐grafts were more frequently associated with endoleaks (25 per cent) than balloon‐expandable stent‐grafts (17 per cent) (P = 0·037).
Conclusion:
Endovascular treatment of AAA is an evolving field. Even after the initial learning curve and attention to device‐related problems, it is still accompanied by a significant number of endoleaks. Uniform presentation of results of treatment is necessary for analysing the effect of differences between patients, aneurysm morphology and device type. © 1999 British Journal of Surgery Society Ltd</description><subject>Aortic Aneurysm, Abdominal - surgery</subject><subject>Biological and medical sciences</subject><subject>Blood Vessel Prosthesis</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Stents</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgical Wound Dehiscence - etiology</subject><subject>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkd9vFCEQgInR2Ovpv2B4ML7tysAusMYXr2mrTVNjrNE3wi5guO6PCmy8--9lvbP2iQzzzcDMhxAGUgKp-NttCYzXBQUuS2iapiQA0JS7J2j1kHiKVoQQUQCj7ASdxrglBBip6XN0AoRxAMFWyJ2PZuqtvsPaJRtwTHZMxc-QI5yC1WnIMZ4c1q2ZBj_qHuspJN9hPdo57OPwDms82KQLnZP76ONCd70ffZfhmGbjbXyBnjndR_vyeK7Rt4vz27OPxfXny09nH66LrqokKSypWN1yx6wBV1EhXFvLmtU2X1YAvDJtDaajtQFCjHSCOgpUC5bnkUZKtkZvDn3vw_RrtjGpwcfO9n3-7TRHxRsJREjI4KsjOLeDNeo--EGHvfq3mQy8PgI65kFc0GPn439ONJxXPGPvD9hv39v9ozZqEaW2avGhFh9qEaX-ilI7tbn6SvNba1Qcyn1e_O6hXIc7xQUTtfp-c6luf9CrL3KzUYz9AZN2lPw</recordid><startdate>199905</startdate><enddate>199905</enddate><creator>Schurink, G. W. H.</creator><creator>Aarts, N. J. M.</creator><creator>van Bockel, J. H.</creator><general>Blackwell Science Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>199905</creationdate><title>Endoleak after stent-graft treatment of abdominal aortic aneurysm: a meta-analysis of clinical studies</title><author>Schurink, G. W. H. ; Aarts, N. J. M. ; van Bockel, J. H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4480-e0435b6f3ed1f4277fb58535e5b641164db51dc25d100d8f72f212a730368d883</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Aortic Aneurysm, Abdominal - surgery</topic><topic>Biological and medical sciences</topic><topic>Blood Vessel Prosthesis</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Stents</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgical Wound Dehiscence - etiology</topic><topic>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schurink, G. W. H.</creatorcontrib><creatorcontrib>Aarts, N. J. M.</creatorcontrib><creatorcontrib>van Bockel, J. H.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schurink, G. W. H.</au><au>Aarts, N. J. M.</au><au>van Bockel, J. H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endoleak after stent-graft treatment of abdominal aortic aneurysm: a meta-analysis of clinical studies</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>1999-05</date><risdate>1999</risdate><volume>86</volume><issue>5</issue><spage>581</spage><epage>587</epage><pages>581-587</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background:
Endoleak is the major complication after endovascular treatment of abdominal aortic aneurysm (AAA) and its incidence seems to remain significant. Little is known about the association of device type and configuration with respect to the incidence, location, time of onset and fate of endoleakage.
Methods:
A meta‐analysis was performed via a Medline search of clinical studies after 1995 dealing with the endovascular treatment of AAA. Details of number of patients treated, configuration and type of endovascular device were collected. Data concerning site of origin, time of occurrence and fate of the endoleak were retrieved, along with information on change in diameter of the aneurysm with time.
Results:
The 23 publications included reported on 1189 patients. The 1118 patients with successfully inserted transfemoral endovascular grafts experienced 270 endoleaks (24 per cent). The majority arose from the distal stent attachment site (36 per cent), were present immediately after stent‐graft placement (66 per cent) and were persistent in time (37 per cent). Tube grafts were more frequently affected by endoleakage (35 per cent; P < 0·0001), especially at the distal stent attachment site (51 per cent), than bifurcated grafts (18 per cent; P = 0·004) and aortounilateral devices (20 per cent; P = 0·70). Self‐ expandable stent‐grafts were more frequently associated with endoleaks (25 per cent) than balloon‐expandable stent‐grafts (17 per cent) (P = 0·037).
Conclusion:
Endovascular treatment of AAA is an evolving field. Even after the initial learning curve and attention to device‐related problems, it is still accompanied by a significant number of endoleaks. Uniform presentation of results of treatment is necessary for analysing the effect of differences between patients, aneurysm morphology and device type. © 1999 British Journal of Surgery Society Ltd</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>10361173</pmid><doi>10.1046/j.1365-2168.1999.01119.x</doi><tpages>7</tpages></addata></record> |
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subjects | Aortic Aneurysm, Abdominal - surgery Biological and medical sciences Blood Vessel Prosthesis Humans Medical sciences Randomized Controlled Trials as Topic Stents Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgical Wound Dehiscence - etiology Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels |
title | Endoleak after stent-graft treatment of abdominal aortic aneurysm: a meta-analysis of clinical studies |
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