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Visceral Aneurysms: Systematic Review and Meta-analysis of Endovascular Versus Open Repair

Visceral Aneurysms: Systematic Review and Meta-analysis of Endovascular Versus Open Repair The aim of this study was to analyse and compare the outcome of open surgery (OS) and endovascular repair (ER) for the treatment of visceral artery aneurysms (VAA). A systematic literature search was carried out. 25 comparative cohort studies with 4447 patients (2469 OS and 1978 ER) were included in the meta-analysis. Mortality (ER vs OS 1.8% vs 2.1%, OR .77, 95% CI [.51; 1.17], P = .23) and technical success rates (97% vs 98%, OR .50, 95% CI [.21; 1.16], P = .11) were comparable between both groups. Lower mortality rates for ER were observed for ruptured aneurysms (4.1% vs 31%, OR .43 95% CI [.13; 1.43], P = .17). Length of stay was shorter (mean difference −4.25 days, 95% CI [−5.52; −2.98], P < .00001) and 1-year reintervention rates were higher in the ER group (9% vs 5%, OR 1.55 95% CI [.58; 4.12], P = .38. The presented evidence suggests that ER should be considered a first-line treatment for VAAs, especially in an emergency setting, due to lower morbidity and comparable mortality and technical success. Follow-up should be offered to these patients due to the higher reintervention rates.Systematic review registrationPROSPERO ID 348699 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Angiology SAGE

Visceral Aneurysms: Systematic Review and Meta-analysis of Endovascular Versus Open Repair

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References (50)

Publisher
SAGE
Copyright
© The Author(s) 2023
ISSN
0003-3197
eISSN
1940-1574
DOI
10.1177/00033197231164286
Publisher site
See Article on Publisher Site

Abstract

The aim of this study was to analyse and compare the outcome of open surgery (OS) and endovascular repair (ER) for the treatment of visceral artery aneurysms (VAA). A systematic literature search was carried out. 25 comparative cohort studies with 4447 patients (2469 OS and 1978 ER) were included in the meta-analysis. Mortality (ER vs OS 1.8% vs 2.1%, OR .77, 95% CI [.51; 1.17], P = .23) and technical success rates (97% vs 98%, OR .50, 95% CI [.21; 1.16], P = .11) were comparable between both groups. Lower mortality rates for ER were observed for ruptured aneurysms (4.1% vs 31%, OR .43 95% CI [.13; 1.43], P = .17). Length of stay was shorter (mean difference −4.25 days, 95% CI [−5.52; −2.98], P < .00001) and 1-year reintervention rates were higher in the ER group (9% vs 5%, OR 1.55 95% CI [.58; 4.12], P = .38. The presented evidence suggests that ER should be considered a first-line treatment for VAAs, especially in an emergency setting, due to lower morbidity and comparable mortality and technical success. Follow-up should be offered to these patients due to the higher reintervention rates.Systematic review registrationPROSPERO ID 348699

Journal

Angiology – SAGE

Published: Jan 1, 2023

Keywords: visceral; aneurysm; endovascular; surgery

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