Effectiveness of endovascular versus open surgical repair for thoracic aortic aneurysm: a systematic review and meta-analysis

Effectiveness of endovascular versus open surgical repair for thoracic aortic aneurysm: a systematic review and meta-analysis


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دانشگاه علوم پزشکی تبریز
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نویسندگان: علیرضا محبوب اهری , فاطمه صادقی غیاثی , فریبا حیدری

کلمات کلیدی: Thoracic aortic aneurysm; Endovascular procedures; Operative surgical procedures; Systematic review

نشریه: 19594 , 1 , 63 , 2022

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نویسنده ثبت کننده مقاله فریبا حیدری
مرحله جاری مقاله تایید نهایی
دانشکده/مرکز مربوطه مرکز تحقیقات پزشکی مبتنی بر شواهد EBM
کد مقاله 78287
عنوان فارسی مقاله Effectiveness of endovascular versus open surgical repair for thoracic aortic aneurysm: a systematic review and meta-analysis
عنوان لاتین مقاله Effectiveness of endovascular versus open surgical repair for thoracic aortic aneurysm: a systematic review and meta-analysis
ناشر 3
آیا مقاله از طرح تحقیقاتی و یا منتورشیپ استخراج شده است؟ بلی
عنوان نشریه (خارج از لیست فوق)
نوع مقاله Systematic Review Article
نحوه ایندکس شدن مقاله ایندکس شده سطح یک – ISI - Web of Science
آدرس لینک مقاله/ همایش در شبکه اینترنت

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Introduction: Since the approval, the thoracic endovascular aortic repair (TEVAR) is widely used for the repair of thoracic aortic aneurysm. However, the long-term mortality and re-intervention rates compared to open surgical repair (OSR) are unclear. We aimed to compare the effectiveness of TEVAR with OSR specifically for thoracic aortic aneurysms. Evidence acquisition: We conducted a comprehensive search in MEDLINE, PubMed, EMBASE, CINAHL, PROSPERO, Centre for Reviews and Dissemination, and the Cochrane Library up to November 2020. The main outcomes were early mortality, mid-to-long-term survival, and re-intervention. The quality of the evidence was assessed using the GRADE methodology. All analyses were performed using RevMan with the random effect model and Comprehensive Meta-Analysis software. Evidence synthesis: One systematic review and 15 individual studies were included. Pooled analysis showed that 30-day mortality, stroke, renal failure, and pulmonary complications were significantly lower in TEVAR versus open surgery. The pooled rate of re-intervention significantly favored the OSR. The long-term survival and mortality favored TEVAR and OSR in one and two studies, respectively, but was non-significant in seven analyzes. Conclusions: Early clinical outcomes including the 30-day mortality, stroke, renal failure, and pulmonary complications significantly favored the TEVAR. However, the mid-to-long-term re-intervention rate favored the OSR and long-term survival was inconsistent among the studies. The quality of evidence was very low. More studies with longer follow-ups are needed. The use of TEVAR should be decided by taking into account other factors including patient characteristics and preferences, cost, and surgeon expertise.

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نویسنده نفر چندم مقاله
علیرضا محبوب اهریاول
فاطمه صادقی غیاثیدوم
فریبا حیدریسوم

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