Comparison of efficiency and safety of open surgery, hybrid surgery and endovascular repair for the treatment of thoracoabdominal aneurysms: a systemic review and network meta-analysis
ObjectiveThe objective of this study was to perform a network meta-analysis (NMA) to assess the efficacy and safety of three different surgical interventions- open surgical repair (OSR), hybrid surgical repair (HSR), and endovascular repair (EVAR)- for the treatment of thoracoabdominal aortic aneury...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-12-01
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| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1257628/full |
| _version_ | 1797390134009659392 |
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| author | Tinghua Liu Jiani Zhao Jinjian Sun Jinjian Sun Kemin Wu Wei Wang Wei Wang |
| author_facet | Tinghua Liu Jiani Zhao Jinjian Sun Jinjian Sun Kemin Wu Wei Wang Wei Wang |
| author_sort | Tinghua Liu |
| collection | DOAJ |
| description | ObjectiveThe objective of this study was to perform a network meta-analysis (NMA) to assess the efficacy and safety of three different surgical interventions- open surgical repair (OSR), hybrid surgical repair (HSR), and endovascular repair (EVAR)- for the treatment of thoracoabdominal aortic aneurysms (TAAAs).MethodsElectronic repositories like PubMed, Embase, Web of Science, Scopus, ScienceDirect, the Cochrane library, Clinical trial, and China National Knowledge Infrastructure (CNKI) were systematically searched to identify studies that compared the efficacy of OSR, HSR, and EVAR with endografts for the treatment of TAAAs until December 24th, 2022. Random-effects and fixed-effects models were employed to analyze the data gathered in a network meta-analysis. The study's primary outcomes of interest encompassed in-hospital mortality, long-term survival rate, and postoperative complications.ResultsEleven comparative studies meet inclusion criterias. There were 2,222 patients in OSR, 1,574 patients in EVAR and 537 patients in HSR. EVAR has lower one-month mortality than OSR (RR: 0.31; 95% CI: 0.17–0.70) and HSR (RR: 0.37; 95% CI: 0.22–0.71), and lower incident rate of renal complications than HSR (RR: 0.20; 95% CI: 0.08–0.43) and OSR (RR: 0.34; 95% CI: 0.16–0.65). Nonetheless, there was no noteworthy discrepancy identified in the long-term survival rates of these procedures.ConclusionsAs compared with OSR, HSR, and EVAR, EVER has lower one-month mortality, and lower incident rates of complications.Systematic review registrationPROSPERO (CRD42022313829). |
| first_indexed | 2024-03-08T23:07:15Z |
| format | Article |
| id | doaj.art-3ed813f673cb4c4991a33fd1a414e89c |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-08T23:07:15Z |
| publishDate | 2023-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-3ed813f673cb4c4991a33fd1a414e89c2023-12-15T10:57:45ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-12-011010.3389/fcvm.2023.12576281257628Comparison of efficiency and safety of open surgery, hybrid surgery and endovascular repair for the treatment of thoracoabdominal aneurysms: a systemic review and network meta-analysisTinghua Liu0Jiani Zhao1Jinjian Sun2Jinjian Sun3Kemin Wu4Wei Wang5Wei Wang6Department of Vascular Surgery, Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Vascular Surgery, Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Vascular Surgery, Xiangya Hospital, Central South University, Changsha, ChinaNational Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Vascular Surgery, Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Vascular Surgery, Xiangya Hospital, Central South University, Changsha, ChinaNational Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, ChinaObjectiveThe objective of this study was to perform a network meta-analysis (NMA) to assess the efficacy and safety of three different surgical interventions- open surgical repair (OSR), hybrid surgical repair (HSR), and endovascular repair (EVAR)- for the treatment of thoracoabdominal aortic aneurysms (TAAAs).MethodsElectronic repositories like PubMed, Embase, Web of Science, Scopus, ScienceDirect, the Cochrane library, Clinical trial, and China National Knowledge Infrastructure (CNKI) were systematically searched to identify studies that compared the efficacy of OSR, HSR, and EVAR with endografts for the treatment of TAAAs until December 24th, 2022. Random-effects and fixed-effects models were employed to analyze the data gathered in a network meta-analysis. The study's primary outcomes of interest encompassed in-hospital mortality, long-term survival rate, and postoperative complications.ResultsEleven comparative studies meet inclusion criterias. There were 2,222 patients in OSR, 1,574 patients in EVAR and 537 patients in HSR. EVAR has lower one-month mortality than OSR (RR: 0.31; 95% CI: 0.17–0.70) and HSR (RR: 0.37; 95% CI: 0.22–0.71), and lower incident rate of renal complications than HSR (RR: 0.20; 95% CI: 0.08–0.43) and OSR (RR: 0.34; 95% CI: 0.16–0.65). Nonetheless, there was no noteworthy discrepancy identified in the long-term survival rates of these procedures.ConclusionsAs compared with OSR, HSR, and EVAR, EVER has lower one-month mortality, and lower incident rates of complications.Systematic review registrationPROSPERO (CRD42022313829).https://www.frontiersin.org/articles/10.3389/fcvm.2023.1257628/fullthoracoabdominal aorta aneurysmopen surgical repairendovascularhybrid surgery repairnetwork meta-analysis (NMA) |
| spellingShingle | Tinghua Liu Jiani Zhao Jinjian Sun Jinjian Sun Kemin Wu Wei Wang Wei Wang Comparison of efficiency and safety of open surgery, hybrid surgery and endovascular repair for the treatment of thoracoabdominal aneurysms: a systemic review and network meta-analysis Frontiers in Cardiovascular Medicine thoracoabdominal aorta aneurysm open surgical repair endovascular hybrid surgery repair network meta-analysis (NMA) |
| title | Comparison of efficiency and safety of open surgery, hybrid surgery and endovascular repair for the treatment of thoracoabdominal aneurysms: a systemic review and network meta-analysis |
| title_full | Comparison of efficiency and safety of open surgery, hybrid surgery and endovascular repair for the treatment of thoracoabdominal aneurysms: a systemic review and network meta-analysis |
| title_fullStr | Comparison of efficiency and safety of open surgery, hybrid surgery and endovascular repair for the treatment of thoracoabdominal aneurysms: a systemic review and network meta-analysis |
| title_full_unstemmed | Comparison of efficiency and safety of open surgery, hybrid surgery and endovascular repair for the treatment of thoracoabdominal aneurysms: a systemic review and network meta-analysis |
| title_short | Comparison of efficiency and safety of open surgery, hybrid surgery and endovascular repair for the treatment of thoracoabdominal aneurysms: a systemic review and network meta-analysis |
| title_sort | comparison of efficiency and safety of open surgery hybrid surgery and endovascular repair for the treatment of thoracoabdominal aneurysms a systemic review and network meta analysis |
| topic | thoracoabdominal aorta aneurysm open surgical repair endovascular hybrid surgery repair network meta-analysis (NMA) |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1257628/full |
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