Ke Kun, Zheng Hui, Yang Weizhu
Department of Interventional Radiology, Affiliated Union Hospital of Fujian Medical University, Fujian, China.
Department of Interventional Radiology, Affiliated Union Hospital of Fujian Medical University, Fujian, China.
Ann Vasc Surg. 2017 Apr;40:112-119. doi: 10.1016/j.avsg.2016.06.030. Epub 2016 Sep 23.
As a novel endovascular treatment, multilayer bare stent implantation remains controversial. This study evaluated the safety and efficacy of multilayer bare stent-based endovascular treatment applied in aortic aneurysms in the reported literature.
Articles regarding multilayer bare stent-based endovascular treatment published before and during February 2016 were obtained by searching PubMed, EMBASE, Wiley Online Library, and Web of Science. R software was employed for a meta-analysis.
Five studies including 154 patients satisfied the inclusion criteria. The mean follow-up was 12.7 (8-22.1) months. The rate of aneurysm exclusion was 76.1%. The rate of aneurysm shrinkage and enlargement was 14.1% and 12.5%, respectively. The patency rate of branch vessels was 98.4%. The overall rate of aneurysm rupture was almost 0%. The 30-day postoperative and 1-year aneurysm-related mortality were 0% and 1.7%, respectively. Technical success was achieved in all patients. Only 6.7% of the patients needed reintervention. About 1.9% of the patients suffered endoleak.
Our study indicates that treatment of aneurysms with multilayer bare stents is safe with high technical success rates and low incidence of complications. However, the low rates of aneurysm exclusion are not negligible. Due to the limitations of the existing studies, we only suggest its use for aortic aneurysms with branch vessels if the standard techniques are contraindicated.
作为一种新型血管内治疗方法,多层裸支架植入术仍存在争议。本研究评估了已发表文献中应用多层裸支架的血管内治疗在主动脉瘤中的安全性和有效性。
通过检索PubMed、EMBASE、Wiley Online Library和Web of Science获取2016年2月之前及期间发表的关于多层裸支架血管内治疗的文章。采用R软件进行荟萃分析。
五项研究共154例患者符合纳入标准。平均随访时间为12.7(8 - 22.1)个月。动脉瘤隔绝率为76.1%。动脉瘤缩小和增大率分别为14.1%和12.5%。分支血管通畅率为98.4%。动脉瘤破裂总发生率几乎为0%。术后30天及1年动脉瘤相关死亡率分别为0%和1.7%。所有患者均取得技术成功。仅6.7%的患者需要再次干预。约1.9%的患者发生内漏。
我们的研究表明,多层裸支架治疗动脉瘤安全,技术成功率高,并发症发生率低。然而,动脉瘤隔绝率较低不容忽视。由于现有研究的局限性,我们仅建议在标准技术禁忌时,将其用于有分支血管的主动脉瘤。