Systematic review of recent evidence for the safety and efficacy of elective endovascular repair in the management of infrarenal abdominal aortic aneurysm

摘要: Background: Conventional management of abdominal aortic aneurysm (AAA) is by open repair and associated with a mortality rate 2–6 per cent. Endovascular (EVAR) an alternative technique first introduced in 1991. A systematic review was undertaken the evidence for safety efficacy elective EVAR asymptomatic infrarenal AAA. Methods: Thirteen electronic bibliographical databases were searched, covering biomedical, health-related, science social literature. Outcomes assessed respect to (successful deployment, technical success, conversion rates secondary intervention rates) (30-day rate, procedure morbidity issues—endoleaks, graft thrombosis, stenosis migration). Results: Of 606 reports identified, 61 met inclusion criteria (three randomized 15 non-randomized controlled trials, 43 uncontrolled studies). There 29 059 participants total; 19 804 underwent EVAR. Deployment successful 97·6 cent cases. Technical success (complete exclusion) 81·9 at discharge 88·8 30 days. Secondary treat endoleak or maintain patency required 16·2 patients. Mean stay intensive care unit mean hospital significantly shorter following The 30-day 1·6 (randomized trials) 2·0 nonrandomized trials case series. complications comprised stent migration (4·0 cent), limb thrombosis (3·9 (type I, 6·8 cent; type II, 10·3 III, 4·2 cent) access artery injury (4·8 cent). Discussion: EVAR technically effective safe, lower short-term than surgery. However, there need extended follow-up as long-term preventing aneurysm-related deaths not yet known. Copyright © 2005 British Journal Surgery Society Ltd. Published John Wiley & Sons,