Abstract
Objectives: There has been a clear move towards endovascular repair of abdominal aortic aneurysms owing to better peri-operative outcomes compared with open surgical repair. However, follow-up has continued to reveal relatively high rates of endoleaks and re-interventions. Improvements in endovascular stent-grafts aim to decrease these complications. This systematic review aims to determine the early outcomes of abdominal aortic aneurysm sealing.
Methods: Standard PRISMA guidelines were followed. A literature search was performed with the aim to extract any publication related to the endovascular aneurysm sealing device.
Results: The total number of patients in this systematic review of 11 studies is 684, with a mean age of 73.2 years, and 587 (88.0%) males. The majority were undergoing elective procedures (n = 606, 91.0%), the remainder as emergencies (n = 30, 4.5% as ruptures, n = 30, 4.5% as symptomatic). Technical success rate including emergency cases was 99.1%. Thirty-day mortality rate was 2.6% (n = 17) including all cases, and 1.0% (n = 6) including elective cases only. Thirty -day endoleak detection rate was 4.7% (n = 31) including all cases, and 4.8% (n = 29) including elective cases only. Thirty-day aneurysm-related re-intervention rate was 5.7% (n = 38) including all cases, and 4.6% (n = 28) including elective cases only. There was no conversion to open surgery within 30 days post-op in the elective cases. There were three delayed conversions to open surgery within 30 days and one report of stent migration causing rupture in the emergency setting.
Conclusions: This novel endovascular aneurysm-sealing device for abdominal aortic aneurysm repair has shown respectable early outcomes. Good technical success rates, in both elective and emergency settings, low rates of all-type endoleaks and low re-intervention rates have all been demonstrated. It is proving to be a safe alternative to open and endovascular aneurysm repair; however, longer term follow-up results are needed to assess the safety and effectiveness of the device in the long term.
Methods: Standard PRISMA guidelines were followed. A literature search was performed with the aim to extract any publication related to the endovascular aneurysm sealing device.
Results: The total number of patients in this systematic review of 11 studies is 684, with a mean age of 73.2 years, and 587 (88.0%) males. The majority were undergoing elective procedures (n = 606, 91.0%), the remainder as emergencies (n = 30, 4.5% as ruptures, n = 30, 4.5% as symptomatic). Technical success rate including emergency cases was 99.1%. Thirty-day mortality rate was 2.6% (n = 17) including all cases, and 1.0% (n = 6) including elective cases only. Thirty -day endoleak detection rate was 4.7% (n = 31) including all cases, and 4.8% (n = 29) including elective cases only. Thirty-day aneurysm-related re-intervention rate was 5.7% (n = 38) including all cases, and 4.6% (n = 28) including elective cases only. There was no conversion to open surgery within 30 days post-op in the elective cases. There were three delayed conversions to open surgery within 30 days and one report of stent migration causing rupture in the emergency setting.
Conclusions: This novel endovascular aneurysm-sealing device for abdominal aortic aneurysm repair has shown respectable early outcomes. Good technical success rates, in both elective and emergency settings, low rates of all-type endoleaks and low re-intervention rates have all been demonstrated. It is proving to be a safe alternative to open and endovascular aneurysm repair; however, longer term follow-up results are needed to assess the safety and effectiveness of the device in the long term.
| Original language | English |
|---|---|
| Pages (from-to) | 423-429 |
| Number of pages | 7 |
| Journal | Vascular |
| Volume | 25 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Aug 2017 |