Shahin Hajibandeh1, Shahab Hajibandeh2, Stavros A Antoniou3, Emma Child4, Francesco Torella2, George A Antoniou5. 1. Liverpool Vascular and Endovascular Service, Royal Liverpool University Hospital & University Hospital Aintree, Liverpool, UK shahin_hajibandeh@yahoo.com. 2. Liverpool Vascular and Endovascular Service, Royal Liverpool University Hospital & University Hospital Aintree, Liverpool, UK. 3. Department of General Surgery, University Hospital of Heraklion, University of Crete, Heraklion, Greece. 4. Library Resource & Information Centre, University Hospital Aintree, Liverpool, UK. 5. Department of Vascular and Endovascular Surgery, The Royal Oldham Hospital, The Pennine Acute Hospitals NHS Trust, Manchester, UK.
Abstract
PURPOSE: Our objective was to undertake a comprehensive review of the literature and conduct an analysis of the outcomes of percutaneous endovascular aneurysm repair. METHODS: MEDLINE; EMBASE; CINAHL; CENTRAL; the World Health Organization International Clinical Trials Registry; ClinicalTrials.gov; and ISRCTN Register, and bibliographic reference lists were searched to identify all studies providing comparative outcomes of the percutaneous technique for endovascular aneurysm repair. Success rate and access-related complications were defined as the primary outcome parameters. Combined overall effect sizes were calculated using fixed effect or random effects models. We conducted a network meta-analysis of different techniques for femoral access applying multivariate meta-analysis assuming consistency. FINDINGS: Three randomised controlled trials and 18 observational studies were identified. Percutaneous access was associated with a lower frequency of groin infection (p < 0.0001) and lymphocele (p = 0.007), and a shorter procedure time (p < 0.0001) and hospital length of stay (p = 0.03) compared with open surgical access. Moreover, percutaneous endovascular aneurysm repair did not increase the risk of haematoma, pseudoaneurysm, and arterial thrombosis or dissection. CONCLUSION: Percutaneous access demonstrates advantages over conventional surgical exposure for endovascular aneurysm repair, as indicated by access-related complications and hospital length of stay. Further research is required to define its impact on resource utilization, cost-effectiveness and quality of life.
PURPOSE: Our objective was to undertake a comprehensive review of the literature and conduct an analysis of the outcomes of percutaneous endovascular aneurysm repair. METHODS: MEDLINE; EMBASE; CINAHL; CENTRAL; the World Health Organization International Clinical Trials Registry; ClinicalTrials.gov; and ISRCTN Register, and bibliographic reference lists were searched to identify all studies providing comparative outcomes of the percutaneous technique for endovascular aneurysm repair. Success rate and access-related complications were defined as the primary outcome parameters. Combined overall effect sizes were calculated using fixed effect or random effects models. We conducted a network meta-analysis of different techniques for femoral access applying multivariate meta-analysis assuming consistency. FINDINGS: Three randomised controlled trials and 18 observational studies were identified. Percutaneous access was associated with a lower frequency of groin infection (p < 0.0001) and lymphocele (p = 0.007), and a shorter procedure time (p < 0.0001) and hospital length of stay (p = 0.03) compared with open surgical access. Moreover, percutaneous endovascular aneurysm repair did not increase the risk of haematoma, pseudoaneurysm, and arterial thrombosis or dissection. CONCLUSION: Percutaneous access demonstrates advantages over conventional surgical exposure for endovascular aneurysm repair, as indicated by access-related complications and hospital length of stay. Further research is required to define its impact on resource utilization, cost-effectiveness and quality of life.
Authors: Johanna Gruel; Eberhard Grambow; Malte Weinrich; Thomas Heller; Justus Groß; Matthias Leuchter; Mark Philipp Journal: J Clin Med Date: 2022-05-27 Impact factor: 4.964
Authors: Raman Uberoi; Carlo Setacci; Mario Lescan; Antonio Lorido; David Murray; Zoltán Szeberin; Tomasz Zubilewicz; Vincent Riambau; Angsu Chartrungsan; Jörg Tessarek Journal: J Endovasc Ther Date: 2018-10-03 Impact factor: 3.487