Papadoulas Spyros, Pitros Christos, Tsimpoukis Andreas, Papageorgopoulou Chrysanthi, Prentza Sofia, Leivaditis Vasileios, Antzoulas Andreas, Mulita Francesk, Moulakakis Konstantinos G
Department of Vascular Surgery, General University Hospital of Patras, Patras, Greece.
Department of Surgery, General University Hospital of Patras, Greece.
Arch Med Sci Atheroscler Dis. 2024 Jul 26;9:e152-e164. doi: 10.5114/amsad/190421. eCollection 2024.
This study presents updated information on post-endovascular aneurysm repair (EVAR) late aortic rupture (LAR) as the data in the literature are limited. It comprises a meta-analysis based on the recent evidence regarding the incidence, causes, treatment outcomes, and prognosis of post-EVAR. A meta-analysis was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were identified by searching electronic databases and scanning bibliographic references from 1991 to April 1, 2023. Our analysis provided evidence that the most common causes of rupture after EVAR were type Ia and Ib Endoleaks (Els). Post-rupture mortality after EVAR was high (35.6%) and comparable to the morbidity of ruptures. Endovascular repair appears to have better results compared to conversion to open repair. A significant number of patients had prior endovascular reoperations and inadequate follow-up. Patient compliance with the surveillance protocol is mandatory.
本研究提供了血管内动脉瘤修复术(EVAR)后晚期主动脉破裂(LAR)的最新信息,因为文献中的数据有限。它包括一项基于近期有关EVAR后发病率、病因、治疗结果和预后证据的荟萃分析。根据PRISMA(系统评价和荟萃分析的首选报告项目)指南进行了荟萃分析。通过检索电子数据库和扫描1991年至2023年4月1日的参考文献来识别研究。我们的分析表明,EVAR后破裂的最常见原因是Ia型和Ib型内漏(Els)。EVAR后破裂后的死亡率很高(35.6%),与破裂的发病率相当。与转为开放修复相比,血管内修复似乎有更好的结果。相当数量的患者曾接受过血管内再次手术且随访不足。患者必须遵守监测方案。