Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Pancreatology. 2021 Jan;21(1):46-58. doi: 10.1016/j.pan.2020.11.017. Epub 2020 Dec 2.
There is a significant variability in the reported outcomes following endovascular embolization of arterial pseudoaneurysms in pancreatitis. The objective of this systematic review and meta-analysis is to evaluate the efficacy of endovascular embolization of pancreatitis-related pseudoaneurysms.
Searches of MEDLINE, EMBASE, and SCOPUS databases were performed through July 1, 2019 in accordance with PRISMA guidelines. All studies with ≥10 patients reporting technical success, clinical success, complications, and mortality were included. Generalized linear mixed method with random effects model was used for assessing pooled incidence rates and corresponding 95% confidence intervals (CIs).
A total of 29 studies (n = 840 with 638 pseudoaneurysms) were included. The pooled incidence rates of pseudoaneurysms in acute and chronic pancreatitis were 0.05% and 0.03%, respectively (odds ratio, 0.91, 95% CI-0.24-3.43). The most common site of pseudoaneurysm was splenic artery (37.7%). The most common embolization agent was coil (n = 415). The follow up period was 54.7 months (range, 21 days to 40.5 months). Pooled technical success rate was 97% (95% CI-92-99%, I 83%). Clinical success rates at ≤3 months, 3-12 months, and >12 months were 82% (95% CI-70-90%, I 42%), 86% (95% CI-75-92%, I 44%), and 88% (95% CI-83-91%, I 0%), respectively. There was no significant difference in the technical or clinical success between acute and chronic pancreatitis on subgroup analysis. Mortality was lower in chronic pancreatitis (OR 4.27 (95% CI 1.35-13.53, I 0%)). Splenic infarction was the most common complication (n = 47).
Endovascular embolization is associated with a high technical and clinical success.
胰腺炎相关动脉假性动脉瘤的血管内栓塞治疗后，其报道的结果存在显著差异。本系统评价和荟萃分析的目的是评估血管内栓塞治疗胰腺炎相关假性动脉瘤的疗效。
根据 PRISMA 指南，于 2019 年 7 月 1 日对 MEDLINE、EMBASE 和 SCOPUS 数据库进行了检索。纳入了所有纳入≥10 例患者报告技术成功率、临床成功率、并发症和死亡率的研究。采用广义线性混合方法（随机效应模型）评估汇总发生率及相应的 95%置信区间（CI）。
共纳入 29 项研究（n=840 例，638 个假性动脉瘤）。急性和慢性胰腺炎的假性动脉瘤发生率分别为 0.05%和 0.03%（比值比，0.91，95%CI-0.24-3.43）。假性动脉瘤最常见的部位是脾动脉（37.7%）。最常用的栓塞剂是线圈（n=415）。随访时间为 54.7 个月（范围，21 天至 40.5 个月）。汇总技术成功率为 97%（95%CI-92-99%，I 83%）。≤3 个月、3-12 个月和>12 个月的临床成功率分别为 82%（95%CI-70-90%，I 42%）、86%（95%CI-75-92%，I 44%）和 88%（95%CI-83-91%，I 0%）。亚组分析显示，急性和慢性胰腺炎的技术成功率和临床成功率无显著差异。慢性胰腺炎的死亡率较低（OR 4.27（95%CI 1.35-13.53，I 0%））。脾梗死是最常见的并发症（n=47）。
血管内栓塞治疗与较高的技术成功率和临床成功率相关。
