37,781例患者择期和急诊腹主动脉瘤开放与血管内修复:系统回顾和荟萃分析

ISRN cardiology Pub Date : 2014-04-02 eCollection Date: 2014-01-01 DOI:10.1155/2014/149243
Dustin M Thomas, Edward A Hulten, Shane T Ellis, David M F Anderson, Nathan Anderson, Fiora McRae, Jamil A Malik, Todd C Villines, Ahmad M Slim
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引用次数: 43

摘要

背景。我们评估了在选择性腹主动脉瘤和破裂腹主动脉瘤(AAA)情况下,与开放式动脉瘤修复(OAR)相比,血管内修复(EVAR)的死亡率和心肌梗死(MI)发生率。方法。基于EVAR和OAR的比较观察和随机对照试验,我们分析了30天死亡率、30天MI和住院时间(LOS)的比率。结果:41项试验比较了EVAR和OAR,共纳入37,781例患者。选择性和破裂的AAA修复有利于EVAR的30天死亡率,合并优势比为0.19 (95% CI 0.17-0.20;I (2) = 88.9%;P < 0.001)。EVAR组共报告1,835例30天心肌梗死事件,而OAR组为2,483例。选择性AAA合并优势比为0.74 (95% CI 0.58-0.96;P = 0.02),有利于EVAR。平均LOS减少296.75小时(95% CI 156.68-436.82小时;P < 0.001)。结论。在选择性和破裂的AAA修复中,EVAR具有较低的30天死亡率、30天心肌梗死和LOS。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Open versus Endovascular Repair of Abdominal Aortic Aneurysm in the Elective and Emergent Setting in a Pooled Population of 37,781 Patients: A Systematic Review and Meta-Analysis.

Open versus Endovascular Repair of Abdominal Aortic Aneurysm in the Elective and Emergent Setting in a Pooled Population of 37,781 Patients: A Systematic Review and Meta-Analysis.

Open versus Endovascular Repair of Abdominal Aortic Aneurysm in the Elective and Emergent Setting in a Pooled Population of 37,781 Patients: A Systematic Review and Meta-Analysis.

Open versus Endovascular Repair of Abdominal Aortic Aneurysm in the Elective and Emergent Setting in a Pooled Population of 37,781 Patients: A Systematic Review and Meta-Analysis.

Background. We evaluated the incidence of mortality and myocardial infarction (MI) in endovascular repair (EVAR) as compared to open aneurysm repair (OAR) in both elective and ruptured abdominal aortic aneurysm (AAA ) setting. Methods. We analyzed the rates of 30-day mortality, 30-day MI, and hospital length of stay (LOS) based on comparative observation and randomized control trials involving EVAR and OAR. Results. 41 trials compared EVAR to OAR with a total pooled population of 37,781 patients. Analysis of elective and ruptured AAA repair favored EVAR with respect to 30-day mortality with a pooled odds ratio of 0.19 (95% CI 0.17-0.20; I (2) = 88.9%; P < 0.001). There were a total of 1,835 30-day MI events reported in the EVAR group as compared to 2,483 events in the OAR group. The pooled odds ratio for elective AAA was 0.74 (95% CI 0.58-0.96; P = 0.02) in favor of EVAR. The average LOS was reduced by 296.75 hrs (95% CI 156.68-436.82 hrs; P < 0.001) in the EVAR population. Conclusions. EVAR has lower rates of 30-day mortality, 30-day MI, and LOS in both elective and ruptured AAA repair.

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