Late Rupture of Abdominal Aortic Aneurysm After Previous Endovascular Repair

作者：George Α. Antoniou, George S. Georgiadis, Stavros A. Antoniou, Simon Neequaye, John A. Brennan, Francesco Torella, S. Rao Vallabhaneni · 发表于：Journal of Endovascular Therapy · 年份：2015 · DOI：10.1177/1526602815601405 · 被引用次数：175 · 研究领域：Aortic aneurysm repair treatments、Aortic Disease and Treatment Approaches、Cardiac, Anesthesia and Surgical Outcomes

PURPOSE: To report a systematic literature review of late rupture of abdominal aortic aneurysm (AAA) after endovascular aneurysm repair (EVAR) and the results of a pooled analysis of causes, treatment, and outcomes. METHODS: Electronic information sources and bibliographic reference lists were interrogated using a combination of free text and controlled vocabulary searches; 11 articles were ultimately identified that fulfilled the inclusion criteria. The articles reported a total of 190 patients who were included in the qualitative and quantitative synthesis. Mortality within 30 days or during the admission with aneurysm rupture was a primary endpoint; major perioperative morbidity was a secondary endpoint. A meta-analysis was performed for 30-day/in-hospital mortality using the random effects model. RESULTS: A total of 152 ruptures occurred after 16,974 EVAR procedures reported by 8 of the case series, giving an incidence of 0.9% [95% confidence interval (CI) 0.77 to 1.05]. The mean time to rupture was 37 months. Twenty-nine percent (95% CI 20 to 39) of the patients had at least one previous secondary endovascular intervention following the initial EVAR, and 37% (95% CI 30 to 45) were not compliant with surveillance. Type I and III endoleaks were the predominant causes of rupture. Open surgical treatment was undertaken in 61% (95% CI 53 to 68) of the patients who underwent treatment. The pooled estimate for perioperative mortality was 32% (95% CI 24 to 41). A significantly l...