Annals of vascular surgery · 2026
Type Ib Endoleak after Endovascular Aortic Repair: Occurrence Rate, Management Strategies, and Outcomes. A Systematic Review and Meta-Analysis.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Cicala Nicola, Di Leo Antonino, Bianchini Massoni Claudio, Maria Pressanto Davide, Daldoss Beatrice, Catasta Alexandra, Freyrie Antonio, Perini Paolo
Аннотация
BACKGROUND: To assess the available evidence on the management and outcomes of type Ib endoleak (TIbEL) after endovascular aortic repair (EVAR).
METHODS: A systematic literature search (MedLine, Web of Science, Scopus, and Cochrane Library) was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number: CRD420261304103). Studies reporting at least 5 cases of TIbEL after EVAR were included. Primary outcomes were technical success (TS), clinical success (CS), and early mortality (≤30 days). Meta-analyses of proportions were performed using a random-effects model.
RESULTS: Thirty-seven studies including 474 patients with 516 TIbEL were analyzed. The estimated occurrence rate of TIbEL was 3.7% (95% CI 2.9-4.5). The weighted mean time from EVAR to TIbEL diagnosis was 39.8 months (95% CI 33.1-46.5). The most frequently adopted treatment approaches were distal stent-graft extension in the common iliac artery (40.9%; 95% CI 23.6-58.2; TS 96.0%), stent-graft extension to the external iliac artery with internal iliac artery embolization (25.9%; 95% CI 15.5-36.4; TS 92.5%), iliac branch endograft (16.3%; 95% CI 2.5-30.2; TS 96.6%), and late open conversion (14.5%; 95% CI 7.3-21.7; TS 90.1%). Overall TS and CS rates were 96.4% (95% CI 94.4% to 98.5%) and 95.5% (95% CI 93% to 98%), respectively. The estimated intraoperative mortality was 3.2% (95% CI 1.3-5.2), while early mortality was 3.4% (95% CI 1.5-5.4). The estimated recurrence rate of TIbEL during follow-up (mean 35.8 months) was 3.3% (95% CI 1.3-5.4).
CONCLUSION: The available evidence indicates that endovascular treatment is the most commonly adopted approach and is associated with high TS.
METHODS: A systematic literature search (MedLine, Web of Science, Scopus, and Cochrane Library) was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number: CRD420261304103). Studies reporting at least 5 cases of TIbEL after EVAR were included. Primary outcomes were technical success (TS), clinical success (CS), and early mortality (≤30 days). Meta-analyses of proportions were performed using a random-effects model.
RESULTS: Thirty-seven studies including 474 patients with 516 TIbEL were analyzed. The estimated occurrence rate of TIbEL was 3.7% (95% CI 2.9-4.5). The weighted mean time from EVAR to TIbEL diagnosis was 39.8 months (95% CI 33.1-46.5). The most frequently adopted treatment approaches were distal stent-graft extension in the common iliac artery (40.9%; 95% CI 23.6-58.2; TS 96.0%), stent-graft extension to the external iliac artery with internal iliac artery embolization (25.9%; 95% CI 15.5-36.4; TS 92.5%), iliac branch endograft (16.3%; 95% CI 2.5-30.2; TS 96.6%), and late open conversion (14.5%; 95% CI 7.3-21.7; TS 90.1%). Overall TS and CS rates were 96.4% (95% CI 94.4% to 98.5%) and 95.5% (95% CI 93% to 98%), respectively. The estimated intraoperative mortality was 3.2% (95% CI 1.3-5.2), while early mortality was 3.4% (95% CI 1.5-5.4). The estimated recurrence rate of TIbEL during follow-up (mean 35.8 months) was 3.3% (95% CI 1.3-5.4).
CONCLUSION: The available evidence indicates that endovascular treatment is the most commonly adopted approach and is associated with high TS.