A systematic review and meta-analysis of thoracic endovascular aortic repair with the proximal landing zone 0
BackgroundThoracic endovascular aortic repair, initially intended for thoracic aortic disease treatment, has extended its application to the proximal zone of the aorta. However, the safety and surgical outcomes of extending the proximal landing zone into the ascending aorta (zone 0) in selected case...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1034354/full |
| _version_ | 1797895398853967872 |
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| author | Longtu Zhu Xiaoye Li Qingsheng Lu |
| author_facet | Longtu Zhu Xiaoye Li Qingsheng Lu |
| author_sort | Longtu Zhu |
| collection | DOAJ |
| description | BackgroundThoracic endovascular aortic repair, initially intended for thoracic aortic disease treatment, has extended its application to the proximal zone of the aorta. However, the safety and surgical outcomes of extending the proximal landing zone into the ascending aorta (zone 0) in selected cases remain unknown. Thus, we performed a systematic review and meta-analysis of zone 0 thoracic endovascular aortic repair (TEVAR) to obtain a deeper understanding of its safety, outcomes, and trends over time.MethodsA literature search was performed using PubMed, EMBASE, and Web of Science databases in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines, from January, 1997 to January, 2022. Only studies involving zone 0 TEVAR were included. The retrieved data from the eligible studies included basic study characteristics, 30-day/in-hospital mortality rate, indications, comorbidities, stent grafts, techniques, and complications. Summary effect measures of the primary outcomes were obtained by logarithmically pooling the data with an inverse variance-weighted fixed-effects model.ResultsFifty-three studies with 1,013 patients were eligible for analysis. The pooled 30-day/in-hospital mortality rate of zone 0 TEVAR was 7.49%. The rates of post-operative stroke, type Ia endoleak, retrograde type A aortic dissection, and spinal cord ischemia were 8.95, 9.01, 5.72, and 4.12%, respectively.ConclusionsAlthough many novel stent grafts and techniques targeting zone 0 TEVAR are being investigated, a consensus on technique and device selection in zone 0 TEVAR is yet to be established in current practice. Furthermore, the post-operative stroke rate is relatively high, while other complication rates and perioperative death rate are comparable to those of TEVAR for other aortic zones. |
| first_indexed | 2024-04-10T07:26:14Z |
| format | Article |
| id | doaj.art-3f025cd8ffa7483f87294d87667ca6e3 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-10T07:26:14Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-3f025cd8ffa7483f87294d87667ca6e32023-02-24T06:15:09ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-02-011010.3389/fcvm.2023.10343541034354A systematic review and meta-analysis of thoracic endovascular aortic repair with the proximal landing zone 0Longtu ZhuXiaoye LiQingsheng LuBackgroundThoracic endovascular aortic repair, initially intended for thoracic aortic disease treatment, has extended its application to the proximal zone of the aorta. However, the safety and surgical outcomes of extending the proximal landing zone into the ascending aorta (zone 0) in selected cases remain unknown. Thus, we performed a systematic review and meta-analysis of zone 0 thoracic endovascular aortic repair (TEVAR) to obtain a deeper understanding of its safety, outcomes, and trends over time.MethodsA literature search was performed using PubMed, EMBASE, and Web of Science databases in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines, from January, 1997 to January, 2022. Only studies involving zone 0 TEVAR were included. The retrieved data from the eligible studies included basic study characteristics, 30-day/in-hospital mortality rate, indications, comorbidities, stent grafts, techniques, and complications. Summary effect measures of the primary outcomes were obtained by logarithmically pooling the data with an inverse variance-weighted fixed-effects model.ResultsFifty-three studies with 1,013 patients were eligible for analysis. The pooled 30-day/in-hospital mortality rate of zone 0 TEVAR was 7.49%. The rates of post-operative stroke, type Ia endoleak, retrograde type A aortic dissection, and spinal cord ischemia were 8.95, 9.01, 5.72, and 4.12%, respectively.ConclusionsAlthough many novel stent grafts and techniques targeting zone 0 TEVAR are being investigated, a consensus on technique and device selection in zone 0 TEVAR is yet to be established in current practice. Furthermore, the post-operative stroke rate is relatively high, while other complication rates and perioperative death rate are comparable to those of TEVAR for other aortic zones.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1034354/fullzone 0 TEVARfenestrated TEVARchimney TEVARhybrid endovascular aortic repairendograftcomplications after TEVAR |
| spellingShingle | Longtu Zhu Xiaoye Li Qingsheng Lu A systematic review and meta-analysis of thoracic endovascular aortic repair with the proximal landing zone 0 Frontiers in Cardiovascular Medicine zone 0 TEVAR fenestrated TEVAR chimney TEVAR hybrid endovascular aortic repair endograft complications after TEVAR |
| title | A systematic review and meta-analysis of thoracic endovascular aortic repair with the proximal landing zone 0 |
| title_full | A systematic review and meta-analysis of thoracic endovascular aortic repair with the proximal landing zone 0 |
| title_fullStr | A systematic review and meta-analysis of thoracic endovascular aortic repair with the proximal landing zone 0 |
| title_full_unstemmed | A systematic review and meta-analysis of thoracic endovascular aortic repair with the proximal landing zone 0 |
| title_short | A systematic review and meta-analysis of thoracic endovascular aortic repair with the proximal landing zone 0 |
| title_sort | systematic review and meta analysis of thoracic endovascular aortic repair with the proximal landing zone 0 |
| topic | zone 0 TEVAR fenestrated TEVAR chimney TEVAR hybrid endovascular aortic repair endograft complications after TEVAR |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1034354/full |
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