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Endovascular versus Open Surgery Repair of Ruptured Abdominal Aortic Aneurysms in Hemodynamically Unstable Patients: Literature Review and Meta-Analysis.
Ann Vasc Surg. 2016 Apr; 32:135-44.AV

Abstract

BACKGROUND

The better outcome achieved by endovascular aortic repair (EVAR) in ruptured abdominal aortic aneurysm (rAAA) patients might derive from the fact that patients with hemodynamic instability preferentially underwent open repair. To further evaluate the effect of EVAR for rAAAs, a meta-analysis of studies in which hemodynamic instability was similar between the 2 treatment groups was conducted.

METHODS

MEDLINE, EMBASE, ISI Web of Knowledge, and the Cochrane Library were searched from January 2004 to May 2014 for randomized controlled trials (RCTs) and observational studies that compared EVAR with open surgery repair in rAAA patients.

RESULTS

Three RCTs and 10 observational studies covering 1,784 patients were included. Perioperative mortality occurred in 27.3% of the patients treated with EVAR and in 38.1% of the patients who underwent open repair. Subgroup analysis revealed consistent results in favor of EVAR in single-center, observational studies. Subgroup analysis and meta-regression analysis indicated that the superior effect of EVAR might be associated with more anatomically suitable patients in EVAR group.

CONCLUSION

The findings from our meta-analysis support EVAR in properly selective rAAA patients.

Authors+Show Affiliations

Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Electronic address: wjpine@hotmail.com.Division of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Electronic address: yaochen_sums@163.com.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

26802303

Citation

Li, Yonghui, et al. "Endovascular Versus Open Surgery Repair of Ruptured Abdominal Aortic Aneurysms in Hemodynamically Unstable Patients: Literature Review and Meta-Analysis." Annals of Vascular Surgery, vol. 32, 2016, pp. 135-44.
Li Y, Li Z, Wang S, et al. Endovascular versus Open Surgery Repair of Ruptured Abdominal Aortic Aneurysms in Hemodynamically Unstable Patients: Literature Review and Meta-Analysis. Ann Vasc Surg. 2016;32:135-44.
Li, Y., Li, Z., Wang, S., Chang, G., Wu, R., Hu, Z., Yin, H., Wang, J., & Yao, C. (2016). Endovascular versus Open Surgery Repair of Ruptured Abdominal Aortic Aneurysms in Hemodynamically Unstable Patients: Literature Review and Meta-Analysis. Annals of Vascular Surgery, 32, 135-44. https://doi.org/10.1016/j.avsg.2015.09.025
Li Y, et al. Endovascular Versus Open Surgery Repair of Ruptured Abdominal Aortic Aneurysms in Hemodynamically Unstable Patients: Literature Review and Meta-Analysis. Ann Vasc Surg. 2016;32:135-44. PubMed PMID: 26802303.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endovascular versus Open Surgery Repair of Ruptured Abdominal Aortic Aneurysms in Hemodynamically Unstable Patients: Literature Review and Meta-Analysis. AU - Li,Yonghui, AU - Li,Zilun, AU - Wang,Shenming, AU - Chang,Guangqi, AU - Wu,Ridong, AU - Hu,Zuojun, AU - Yin,Henghui, AU - Wang,Jingsong, AU - Yao,Chen, Y1 - 2016/01/21/ PY - 2015/03/10/received PY - 2015/09/18/revised PY - 2015/09/25/accepted PY - 2016/1/24/entrez PY - 2016/1/24/pubmed PY - 2016/12/15/medline SP - 135 EP - 44 JF - Annals of vascular surgery JO - Ann Vasc Surg VL - 32 N2 - BACKGROUND: The better outcome achieved by endovascular aortic repair (EVAR) in ruptured abdominal aortic aneurysm (rAAA) patients might derive from the fact that patients with hemodynamic instability preferentially underwent open repair. To further evaluate the effect of EVAR for rAAAs, a meta-analysis of studies in which hemodynamic instability was similar between the 2 treatment groups was conducted. METHODS: MEDLINE, EMBASE, ISI Web of Knowledge, and the Cochrane Library were searched from January 2004 to May 2014 for randomized controlled trials (RCTs) and observational studies that compared EVAR with open surgery repair in rAAA patients. RESULTS: Three RCTs and 10 observational studies covering 1,784 patients were included. Perioperative mortality occurred in 27.3% of the patients treated with EVAR and in 38.1% of the patients who underwent open repair. Subgroup analysis revealed consistent results in favor of EVAR in single-center, observational studies. Subgroup analysis and meta-regression analysis indicated that the superior effect of EVAR might be associated with more anatomically suitable patients in EVAR group. CONCLUSION: The findings from our meta-analysis support EVAR in properly selective rAAA patients. SN - 1615-5947 UR - https://www.unboundmedicine.com/medline/citation/26802303/Endovascular_versus_Open_Surgery_Repair_of_Ruptured_Abdominal_Aortic_Aneurysms_in_Hemodynamically_Unstable_Patients:_Literature_Review_and_Meta_Analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0890-5096(16)00049-2 DB - PRIME DP - Unbound Medicine ER -