Annals of vascular surgery · 2025
Balloon-Expandable Versus Self-Expandable Stent Grafts for Endovascular Repair of Aorto-Iliac Aneurysms with Iliac Branch Devices: A Systematic Review and Meta-Analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Pimentel-Junior Dilson, Mastra Milena Monteiro, Bertolino Enrico Prajiante, Fernandez Miguel Godeiro, Filippini Denise, Obara Mariana K, De Melo Neto Carlos Bm, Lima Guilherme B, De Luccia Nelson, Mulatti Grace Carvajal
Аннотация
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.
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.
Предметные рубрики MeSH
HumansIliac AneurysmBlood Vessel ProsthesisBlood Vessel Prosthesis ImplantationProsthesis DesignTreatment OutcomeMaleRisk FactorsAgedStentsFemalePostoperative ComplicationsMiddle AgedEndovascular ProceduresRisk AssessmentAortic Aneurysm, AbdominalAngioplasty, BalloonEndoleakAged, 80 and overTime Factors