State of the art and meta-analysis of secondary open aortic procedure after abdominal endovascular aortic repair

摘要: Abstract Background Secondary open aortic procedures (SOAP) treat complications of endovascular aneurysm repair, when further options are exhausted. We aimed at depicting the state art SOAP with high-level evidence. Methods A systematic review literature, a meta-analysis its outcomes (primary outcome operative mortality; secondary major morbidity) and metaregression risk factors for mortality (PROSPERO 42017075631). Results Twenty-eight studies (1093 patients) were elected analysis. was performed within same hospitalization or 30 days from domestic repair (early SOAP) in 0.2% patients (85/40,256), nonelective setting 24.3% (95% confidence interval, 21.8-26.9). Most frequent indications endoleak (44.4%; 95% 41.4-47.3) rupture (12.7%; 10.4-15.1). The most common were infrarenal replacement (85.2%; 82.6-87.7) high use supravisceral clamping (suprarenal, 25% [95% 21.9-28.1] supraceliac, 20.7% 17.8-23.6]), axillobifemoral bypass stent explant (6.9%; 5.1-8.7). Operative (in-hospital 30-day) 10.9% 8.7-13.5). morbidities were respiratory (11.4%; 8.1-15.9) renal (9.5%; 8.1-15.9). Risk (Z = 3.007; Q = 9.044; P = .003) status 3.382; Q = 11.440; .001). Conclusions Endoleak is main indication SOAP, which mostly consists infrarenal replacement. clamping.