气囊可膨胀与自膨胀支架移植用于髂分支装置血管内修复主动脉-髂动脉瘤：系统回顾和荟萃分析。

IF 1.6 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Annals of vascular surgery Pub Date : 2025-09-03 DOI:10.1016/j.avsg.2025.08.037

Dilson Pimentel-Junior , Milena Monteiro Mastra , Enrico Prajiante Bertolino , Miguel Godeiro Fernandez , Denise Filippini , Mariana K. Obara , Carlos BM. De Melo Neto , Guilherme B. Lima , Nelson De Luccia , Grace Carvajal Mulatti

{"title":"气囊可膨胀与自膨胀支架移植用于髂分支装置血管内修复主动脉-髂动脉瘤：系统回顾和荟萃分析。","authors":"Dilson Pimentel-Junior , Milena Monteiro Mastra , Enrico Prajiante Bertolino , Miguel Godeiro Fernandez , Denise Filippini , Mariana K. Obara , Carlos BM. De Melo Neto , Guilherme B. Lima , Nelson De Luccia , Grace Carvajal Mulatti","doi":"10.1016/j.avsg.2025.08.037","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>To compare the results of internal iliac artery (IIA) incorporation using balloon-expandable stent grafts (BESGs) versus self-expandable stent grafts (SESGs) while using iliac branch devices (IBDs) for endovascular repair of aorto-iliac artery aneurysms.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis was conducted. PubMed, Embase, and Cochrane databases were searched for studies up to December 2024 that compared BESG and SESG for IBD during endovascular repair of aorto-iliac aneurysms. A total of 1,107 articles were screened following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. End points included a composite of all endoleaks, types 1b, 1c, and 3 endoleaks, buttock claudication, IIA occlusion, and IBD-related reinterventions during follow-up.</div></div><div><h3>Results</h3><div>Four cohort studies met the eligibility criteria with 684 patients treated with 711 IBDs. 460 (64.7%) BESGs and 251 (35.3%) SESGs were used in the target IIAs. Both groups had similar demographics and cardiovascular risk factors. The median age of patients was 71.1 years and 88.7% were male. A composite of all endoleaks (odds ratio [OR]: 5.53; 95% confidence interval [CI]: 1.15 to 26.63; <em>P</em> = 0.03; I<sup>2</sup> = 0) was significantly less common in patients treated with SESG compared to BESG. Type 1b (OR: 4.62; 95% CI: 0.18–116.16; <em>P</em> = 0.35), type 1c (OR: 1.52; 95% CI: 0.09–25.03; <em>P</em> = 0.77), type 3 endoleaks (OR: 5.25; 95% CI: 0.58–47.47; <em>P</em> = 0.14), buttock claudication (OR: 0.38; 95% CI: 0.06–2.58; <em>P</em> = 0.32; I<sup>2</sup> = 0%), IIA occlusion (OR: 0.40; 95% CI: 0.06–2.57; <em>P</em> = 0.34; I<sup>2</sup> = 0%), and IBD-related reinterventions (OR: 1.62; 95% CI: 0.84–3.11; <em>P</em> = 0.15; I<sup>2</sup> = 0%) were not significantly different between groups.</div></div><div><h3>Conclusion</h3><div>SESG for IIA was associated with a lower incidence of all types of endoleaks when compared to BESG during endovascular repair of aorto-iliac aneurysms using IBD. However, types 1b, 1c, and 3 endoleaks; buttock claudication; IIA occlusion; and IBD-related reinterventions were similar among SESG and BESG. BESG is more versatile to adjust to challenging anatomical conditions.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"122 ","pages":"Pages 552-563"},"PeriodicalIF":1.6000,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Balloon-Expandable Versus Self-Expandable Stent Grafts for Endovascular Repair of Aorto-Iliac Aneurysms with Iliac Branch Devices: A Systematic Review and Meta-Analysis\",\"authors\":\"Dilson Pimentel-Junior , Milena Monteiro Mastra , Enrico Prajiante Bertolino , Miguel Godeiro Fernandez , Denise Filippini , Mariana K. Obara , Carlos BM. De Melo Neto , Guilherme B. Lima , Nelson De Luccia , Grace Carvajal Mulatti\",\"doi\":\"10.1016/j.avsg.2025.08.037\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>To compare the results of internal iliac artery (IIA) incorporation using balloon-expandable stent grafts (BESGs) versus self-expandable stent grafts (SESGs) while using iliac branch devices (IBDs) for endovascular repair of aorto-iliac artery aneurysms.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis was conducted. PubMed, Embase, and Cochrane databases were searched for studies up to December 2024 that compared BESG and SESG for IBD during endovascular repair of aorto-iliac aneurysms. A total of 1,107 articles were screened following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. End points included a composite of all endoleaks, types 1b, 1c, and 3 endoleaks, buttock claudication, IIA occlusion, and IBD-related reinterventions during follow-up.</div></div><div><h3>Results</h3><div>Four cohort studies met the eligibility criteria with 684 patients treated with 711 IBDs. 460 (64.7%) BESGs and 251 (35.3%) SESGs were used in the target IIAs. Both groups had similar demographics and cardiovascular risk factors. The median age of patients was 71.1 years and 88.7% were male. A composite of all endoleaks (odds ratio [OR]: 5.53; 95% confidence interval [CI]: 1.15 to 26.63; <em>P</em> = 0.03; I<sup>2</sup> = 0) was significantly less common in patients treated with SESG compared to BESG. Type 1b (OR: 4.62; 95% CI: 0.18–116.16; <em>P</em> = 0.35), type 1c (OR: 1.52; 95% CI: 0.09–25.03; <em>P</em> = 0.77), type 3 endoleaks (OR: 5.25; 95% CI: 0.58–47.47; <em>P</em> = 0.14), buttock claudication (OR: 0.38; 95% CI: 0.06–2.58; <em>P</em> = 0.32; I<sup>2</sup> = 0%), IIA occlusion (OR: 0.40; 95% CI: 0.06–2.57; <em>P</em> = 0.34; I<sup>2</sup> = 0%), and IBD-related reinterventions (OR: 1.62; 95% CI: 0.84–3.11; <em>P</em> = 0.15; I<sup>2</sup> = 0%) were not significantly different between groups.</div></div><div><h3>Conclusion</h3><div>SESG for IIA was associated with a lower incidence of all types of endoleaks when compared to BESG during endovascular repair of aorto-iliac aneurysms using IBD. However, types 1b, 1c, and 3 endoleaks; buttock claudication; IIA occlusion; and IBD-related reinterventions were similar among SESG and BESG. BESG is more versatile to adjust to challenging anatomical conditions.</div></div>\",\"PeriodicalId\":8061,\"journal\":{\"name\":\"Annals of vascular surgery\",\"volume\":\"122 \",\"pages\":\"Pages 552-563\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-09-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of vascular surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0890509625005904\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of vascular surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0890509625005904","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}

引用次数: 0

摘要

背景：比较使用球囊可膨胀支架（BESG）与自膨胀支架（SESG）合并髂内动脉（IIA）的结果，同时使用髂分支装置（IBD）进行主动脉-髂动脉瘤的血管内修复。方法：进行系统综述和荟萃分析。PubMed、Embase和Cochrane数据库检索了截至2024年12月的研究，这些研究比较了主动脉髂动脉瘤血管内修复期间IBD的BESG和SESG。按照PRISMA方案共筛选了1107篇文章。终点包括所有内漏，1b型，1c型和3型内漏，臀部跛行，IIA闭塞，以及随访期间ibd相关的再干预。结果：4项队列研究符合入选标准，684例ibd患者接受了711例ibd治疗。460例（64.7%）采用BESG， 251例（35.3%）采用SESG。两组的人口统计数据和心血管危险因素相似。患者中位年龄为71.1岁，男性占88.7%。与BESG治疗的患者相比，SESG治疗的所有内漏（OR 5.53; 95% CI 1.15至26.63；P= 0.03;I2= 0）的发生率明显低于BESG治疗。1 b型(或4.62;95%可信区间0.18 - 116.16;P = .35点),1型c(或1.52;95%可信区间0.09 - 25.03;P = .77点),3型endoleaks(或5.25;95%可信区间0.58 - 47.47;P = .14点),臀部跛行(或0.38;95%可信区间0.06 - 2.58;P = 32, I2 = 0%),活动花絮闭塞(或0.40;95%可信区间0.06 - 2.57;P =点;I2 = 0%),和IBD-related reinterventions(或1.62;95%可信区间0.84 - 3.11;P =含量;I2 = 0%)组之间没有显著差异。结论：在使用IBD进行主动脉髂动脉瘤血管内修复时，与BESG相比，SESG治疗IIA与所有类型的内漏发生率较低相关。然而，1b型、1c型、3型内漏、臀部跛行、IIA闭塞和ibd相关再干预在SESG和BESG中相似。BESG更通用，以适应具有挑战性的解剖条件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Balloon-Expandable Versus Self-Expandable Stent Grafts for Endovascular Repair of Aorto-Iliac Aneurysms with Iliac Branch Devices: A Systematic Review and Meta-Analysis

Background

To compare the results of internal iliac artery (IIA) incorporation using balloon-expandable stent grafts (BESGs) versus self-expandable stent grafts (SESGs) while using iliac branch devices (IBDs) for endovascular repair of aorto-iliac artery aneurysms.

Methods

A systematic review and meta-analysis was conducted. PubMed, Embase, and Cochrane databases were searched for studies up to December 2024 that compared BESG and SESG for IBD during endovascular repair of aorto-iliac aneurysms. A total of 1,107 articles were screened following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. End points included a composite of all endoleaks, types 1b, 1c, and 3 endoleaks, buttock claudication, IIA occlusion, and IBD-related reinterventions during follow-up.

Results

Four cohort studies met the eligibility criteria with 684 patients treated with 711 IBDs. 460 (64.7%) BESGs and 251 (35.3%) SESGs were used in the target IIAs. Both groups had similar demographics and cardiovascular risk factors. The median age of patients was 71.1 years and 88.7% were male. A composite of all endoleaks (odds ratio [OR]: 5.53; 95% confidence interval [CI]: 1.15 to 26.63; P = 0.03; I² = 0) was significantly less common in patients treated with SESG compared to BESG. Type 1b (OR: 4.62; 95% CI: 0.18–116.16; P = 0.35), type 1c (OR: 1.52; 95% CI: 0.09–25.03; P = 0.77), type 3 endoleaks (OR: 5.25; 95% CI: 0.58–47.47; P = 0.14), buttock claudication (OR: 0.38; 95% CI: 0.06–2.58; P = 0.32; I² = 0%), IIA occlusion (OR: 0.40; 95% CI: 0.06–2.57; P = 0.34; I² = 0%), and IBD-related reinterventions (OR: 1.62; 95% CI: 0.84–3.11; P = 0.15; I² = 0%) were not significantly different between groups.

Conclusion

SESG for IIA was associated with a lower incidence of all types of endoleaks when compared to BESG during endovascular repair of aorto-iliac aneurysms using IBD. However, types 1b, 1c, and 3 endoleaks; buttock claudication; IIA occlusion; and IBD-related reinterventions were similar among SESG and BESG. BESG is more versatile to adjust to challenging anatomical conditions.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Annals of vascular surgery 医学-外科

CiteScore

3.00

自引率

13.30%

发文量

603

审稿时长

50 days

期刊介绍： Annals of Vascular Surgery, published eight times a year, invites original manuscripts reporting clinical and experimental work in vascular surgery for peer review. Articles may be submitted for the following sections of the journal: Clinical Research (reports of clinical series, new drug or medical device trials) Basic Science Research (new investigations, experimental work) Case Reports (reports on a limited series of patients) General Reviews (scholarly review of the existing literature on a relevant topic) Developments in Endovascular and Endoscopic Surgery Selected Techniques (technical maneuvers) Historical Notes (interesting vignettes from the early days of vascular surgery) Editorials/Correspondence