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Review
. 2014 Apr 2:2014:149243.
doi: 10.1155/2014/149243. eCollection 2014.

Open versus Endovascular Repair of Abdominal Aortic Aneurysm in the Elective and Emergent Setting in a Pooled Population of 37,781 Patients: A Systematic Review and Meta-Analysis

Dustin M Thomas  1 , Edward A Hulten  2 , Shane T Ellis  3 , David M F Anderson  3 , Nathan Anderson  1 , Fiora McRae  1 , Jamil A Malik  1 , Todd C Villines  2 , Ahmad M Slim  1
Affiliations
Review

Open versus Endovascular Repair of Abdominal Aortic Aneurysm in the Elective and Emergent Setting in a Pooled Population of 37,781 Patients: A Systematic Review and Meta-Analysis

Dustin M Thomas et al. ISRN Cardiol. .

Abstract

Background. We evaluated the incidence of mortality and myocardial infarction (MI) in endovascular repair (EVAR) as compared to open aneurysm repair (OAR) in both elective and ruptured abdominal aortic aneurysm (AAA ) setting. Methods. We analyzed the rates of 30-day mortality, 30-day MI, and hospital length of stay (LOS) based on comparative observation and randomized control trials involving EVAR and OAR. Results. 41 trials compared EVAR to OAR with a total pooled population of 37,781 patients. Analysis of elective and ruptured AAA repair favored EVAR with respect to 30-day mortality with a pooled odds ratio of 0.19 (95% CI 0.17-0.20; I (2) = 88.9%; P < 0.001). There were a total of 1,835 30-day MI events reported in the EVAR group as compared to 2,483 events in the OAR group. The pooled odds ratio for elective AAA was 0.74 (95% CI 0.58-0.96; P = 0.02) in favor of EVAR. The average LOS was reduced by 296.75 hrs (95% CI 156.68-436.82 hrs; P < 0.001) in the EVAR population. Conclusions. EVAR has lower rates of 30-day mortality, 30-day MI, and LOS in both elective and ruptured AAA repair.

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Figures

Figure 1
Figure 1
Flow diagram of articles evaluated that did not meet inclusion/exclusion criteria during the search period.
Figure 2
Figure 2
Odd ratio of mortality risk in OAR as compared to EVAR in the elective as well as the emergent (ruptured) setting.
Figure 3
Figure 3
Odd ratio of mortality risk in OAR as compared to EVAR randomized clinical trials.
Figure 4
Figure 4
Odd ratio of myocardial infarction risk in OAR as compared to EVAR in the elective as well as the emergent (ruptured) setting.
Figure 5
Figure 5
Comparison of reported hospital length of stay between OR and EVAR.
See this image and copyright information in PMC

References

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