Sinan Deniz, Elif Öcal, Muzaffer Reha Ümütlü, Moritz Wildgruber, Jens Ricke, Max Seidensticker, Osman Öcal
{"title":"支架植入术治疗肝动脉出血：系统回顾和荟萃分析。","authors":"Sinan Deniz, Elif Öcal, Muzaffer Reha Ümütlü, Moritz Wildgruber, Jens Ricke, Max Seidensticker, Osman Öcal","doi":"10.1186/s42155-025-00608-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this systematic review and meta-analysis was to identify the technical and clinical outcomes of stent-graft implantation in patients with hepatic artery bleeding.</p><p><strong>Materials and methods: </strong>The PubMed database was searched for publications between 2000 and March 2025 evaluating patients treated with stent-graft implantation for hepatic arterial hemorrhage. The outcome measurements were technical (successful hemostasis with stent-grafts) and clinical success (no rebleeding from hepatic arteries), early mortality, and stent-graft patency during follow-up. A modified Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included publications. An individual patient data meta-analysis was performed using the chi-square test or Fischer exact test to identify predictors of stent-graft patency.</p><p><strong>Results: </strong>In total, 351 patients from 22 studies were included. The mean NOS score was 5.4 ± 0.95. Most patients (n = 323) had bleeding after surgery. The technical success rate of stent-graft placement was 94.3%. Patients with technical failure were managed either by surgery (n = 10) or coil embolization of the hepatic artery (n = 10). Rebleeding from hepatic arteries was seen in 24 patients with a clinical success rate of 92.7%. The early mortality rate was 15.6%. Follow-up showed stent-graft patency in 76.5% (202 of 264) of the cases. Most of the stent-graft occlusions (51/62, 82.2%) were asymptomatic. No significant difference was seen in the rate of stent-graft patency between patients receiving acetylsalicylic acid or not, or dual antiplatelet treatment or not. Overlapping stent-grafts (p = 0.009) were significant risk factors for stent-graft occlusion.</p><p><strong>Conclusion: </strong>Stent-graft implantation in hepatic arterial bleeding is associated with high technical and clinical success rates. Despite the considerable rate of stent-graft occlusion during follow-up, occlusion is mostly asymptomatic, probably due to collateral development.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"80"},"PeriodicalIF":1.5000,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518196/pdf/","citationCount":"0","resultStr":"{\"title\":\"Stent-graft implantation for hepatic arterial bleeding: a systematic review and meta-analysis.\",\"authors\":\"Sinan Deniz, Elif Öcal, Muzaffer Reha Ümütlü, Moritz Wildgruber, Jens Ricke, Max Seidensticker, Osman Öcal\",\"doi\":\"10.1186/s42155-025-00608-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The aim of this systematic review and meta-analysis was to identify the technical and clinical outcomes of stent-graft implantation in patients with hepatic artery bleeding.</p><p><strong>Materials and methods: </strong>The PubMed database was searched for publications between 2000 and March 2025 evaluating patients treated with stent-graft implantation for hepatic arterial hemorrhage. The outcome measurements were technical (successful hemostasis with stent-grafts) and clinical success (no rebleeding from hepatic arteries), early mortality, and stent-graft patency during follow-up. A modified Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included publications. An individual patient data meta-analysis was performed using the chi-square test or Fischer exact test to identify predictors of stent-graft patency.</p><p><strong>Results: </strong>In total, 351 patients from 22 studies were included. The mean NOS score was 5.4 ± 0.95. Most patients (n = 323) had bleeding after surgery. The technical success rate of stent-graft placement was 94.3%. Patients with technical failure were managed either by surgery (n = 10) or coil embolization of the hepatic artery (n = 10). Rebleeding from hepatic arteries was seen in 24 patients with a clinical success rate of 92.7%. The early mortality rate was 15.6%. Follow-up showed stent-graft patency in 76.5% (202 of 264) of the cases. Most of the stent-graft occlusions (51/62, 82.2%) were asymptomatic. No significant difference was seen in the rate of stent-graft patency between patients receiving acetylsalicylic acid or not, or dual antiplatelet treatment or not. Overlapping stent-grafts (p = 0.009) were significant risk factors for stent-graft occlusion.</p><p><strong>Conclusion: </strong>Stent-graft implantation in hepatic arterial bleeding is associated with high technical and clinical success rates. Despite the considerable rate of stent-graft occlusion during follow-up, occlusion is mostly asymptomatic, probably due to collateral development.</p>\",\"PeriodicalId\":52351,\"journal\":{\"name\":\"CVIR Endovascular\",\"volume\":\"8 1\",\"pages\":\"80\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-10-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518196/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"CVIR Endovascular\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s42155-025-00608-0\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"CVIR Endovascular","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s42155-025-00608-0","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Stent-graft implantation for hepatic arterial bleeding: a systematic review and meta-analysis.
Purpose: The aim of this systematic review and meta-analysis was to identify the technical and clinical outcomes of stent-graft implantation in patients with hepatic artery bleeding.
Materials and methods: The PubMed database was searched for publications between 2000 and March 2025 evaluating patients treated with stent-graft implantation for hepatic arterial hemorrhage. The outcome measurements were technical (successful hemostasis with stent-grafts) and clinical success (no rebleeding from hepatic arteries), early mortality, and stent-graft patency during follow-up. A modified Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included publications. An individual patient data meta-analysis was performed using the chi-square test or Fischer exact test to identify predictors of stent-graft patency.
Results: In total, 351 patients from 22 studies were included. The mean NOS score was 5.4 ± 0.95. Most patients (n = 323) had bleeding after surgery. The technical success rate of stent-graft placement was 94.3%. Patients with technical failure were managed either by surgery (n = 10) or coil embolization of the hepatic artery (n = 10). Rebleeding from hepatic arteries was seen in 24 patients with a clinical success rate of 92.7%. The early mortality rate was 15.6%. Follow-up showed stent-graft patency in 76.5% (202 of 264) of the cases. Most of the stent-graft occlusions (51/62, 82.2%) were asymptomatic. No significant difference was seen in the rate of stent-graft patency between patients receiving acetylsalicylic acid or not, or dual antiplatelet treatment or not. Overlapping stent-grafts (p = 0.009) were significant risk factors for stent-graft occlusion.
Conclusion: Stent-graft implantation in hepatic arterial bleeding is associated with high technical and clinical success rates. Despite the considerable rate of stent-graft occlusion during follow-up, occlusion is mostly asymptomatic, probably due to collateral development.
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