European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery · 2025
Systematic Review and Meta-analysis of Outcomes of the Advanta V12 or iCAST Bridging Stent Graft Used for Fenestrated and Branched Endovascular Aortic Repair.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Nana Petroula, Dakis Konstantinos, Brodis Alexandros, Torrealba José I, Panuccio Giuseppe, Spanos Konstantinos, Kölbel Tilo
Аннотация
OBJECTIVE: Half of re-interventions after fenestrated and branched endovascular aortic repair (FB-EVAR) are target vessel related. Regarding bridging stent choice, existing data are controversial. This meta-analysis aimed to evaluate the performance of Advanta V12/iCAST as the bridging stent in FB-EVAR.
DATA SOURCES: The English medical literature was searched through MEDLINE, Embase (via Ovid), and Cochrane databases (end date 15 April 2024).
REVIEW METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and PICO (Patient, Intervention, Comparison, Outcome) model were followed. A predefined protocol was registered to PROSPERO (CRD42024556603). Randomised controlled trials and observational studies (2010 - 2024) reporting on Advanta V12/iCAST related target vessel outcomes were eligible. Risk of bias was assessed using ROBINS-I, and evidence quality was assessed via Grading of Recommendations Assessment, Development and Evaluations (GRADE). Primary outcomes were freedom from instability, stenosis and or occlusion, types Ic and IIIc endoleak, and re-intervention of target vessels bridged with the Advanta V12/iCAST. Prevalence and regression meta-analysis were performed.
RESULTS: From 1 439 articles, ten retrospective studies (7 525 target vessels; 3 890 target vessels bridged with Advanta V12/iCAST) were included. According to ROBINS-I, no study was of high quality. Mean follow up was 24.3 (95% confidence interval [CI] 23.9 - 24.7) months. Freedom from instability, stenosis and or occlusion, and types Ic and IIIc endoleak were 94% (95% CI 91 - 96%; p < .010; I2 = 91%; GRADE certainty, very low), 97% (95% CI 96 - 98%; p = .070, I2 = 44%; GRADE certainty, low), and 97% (95% CI 94 - 98%; p < .010; I2 = 81%; GRADE certainty, very low), respectively. Freedom from target vessel re-intervention was 95% (95% CI 92 - 97%; p < .010; I2 = 85%; GRADE certainty, very low). Four studies provided extractable data on Advanta V12/iCAST in fenestrations and four in branches. No difference was detected in freedom from instability (p = .47), stenosis and or occlusion (p = .36), and types Ic and IIIc endoleak (p = .90). Freedom from re-intervention was 93% (95% CI 87 - 96%; p < .010; I2 = 90%) in fenestrations and 95% (95% CI 91 - 97%; p = .060, I2 = 64%) in branches.
CONCLUSION: The Advanta V12/iCAST bridging stent showed high freedom from target vessel instability, stenosis and or occlusion, and endoleak. Freedom from re-intervention was 95%, being similarly high in fenestrations and branches.
DATA SOURCES: The English medical literature was searched through MEDLINE, Embase (via Ovid), and Cochrane databases (end date 15 April 2024).
REVIEW METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and PICO (Patient, Intervention, Comparison, Outcome) model were followed. A predefined protocol was registered to PROSPERO (CRD42024556603). Randomised controlled trials and observational studies (2010 - 2024) reporting on Advanta V12/iCAST related target vessel outcomes were eligible. Risk of bias was assessed using ROBINS-I, and evidence quality was assessed via Grading of Recommendations Assessment, Development and Evaluations (GRADE). Primary outcomes were freedom from instability, stenosis and or occlusion, types Ic and IIIc endoleak, and re-intervention of target vessels bridged with the Advanta V12/iCAST. Prevalence and regression meta-analysis were performed.
RESULTS: From 1 439 articles, ten retrospective studies (7 525 target vessels; 3 890 target vessels bridged with Advanta V12/iCAST) were included. According to ROBINS-I, no study was of high quality. Mean follow up was 24.3 (95% confidence interval [CI] 23.9 - 24.7) months. Freedom from instability, stenosis and or occlusion, and types Ic and IIIc endoleak were 94% (95% CI 91 - 96%; p < .010; I2 = 91%; GRADE certainty, very low), 97% (95% CI 96 - 98%; p = .070, I2 = 44%; GRADE certainty, low), and 97% (95% CI 94 - 98%; p < .010; I2 = 81%; GRADE certainty, very low), respectively. Freedom from target vessel re-intervention was 95% (95% CI 92 - 97%; p < .010; I2 = 85%; GRADE certainty, very low). Four studies provided extractable data on Advanta V12/iCAST in fenestrations and four in branches. No difference was detected in freedom from instability (p = .47), stenosis and or occlusion (p = .36), and types Ic and IIIc endoleak (p = .90). Freedom from re-intervention was 93% (95% CI 87 - 96%; p < .010; I2 = 90%) in fenestrations and 95% (95% CI 91 - 97%; p = .060, I2 = 64%) in branches.
CONCLUSION: The Advanta V12/iCAST bridging stent showed high freedom from target vessel instability, stenosis and or occlusion, and endoleak. Freedom from re-intervention was 95%, being similarly high in fenestrations and branches.