Key result
Following thoracic endovascular aortic repair, the pooled rate of endograft migration was 4% (95% CI, 2%-7%), with associated pooled morbidity of 31% and mortality of 5%.
Why the study?
Evidence-based data were needed regarding the cumulative incidence of endograft migration and its patient-relevant sequelae, including morbidity, reintervention, and mortality, after TEVAR using contemporary endografts.
Meta-Analysis (n=1,783)
Answers are grounded in this paper and cite their sources.
Endograft migration after TEVAR occurs in approximately 4% of patients and is associated with significant morbidity, reintervention, and mortality, highlighting the need for close standardized surveillance.
PURPOSE: The objective of this systematic review was to report the cumulative incidence of endograft migration (EM), as well as the morbidity, reintervention rates, and mortality related to EM. This study aimed to provide evidence-based data on patient-relevant sequelae of EM after thoracic endovascular aortic repair (TEVAR) performed using contemporary aortic endografts. MATERIALS AND METHODS: A systematic electronic search of literature in MEDLINE (via PubMed), Web of Science, and Cochrane Central Register of Controlled Trials was performed. The pooled synthesis of outcomes was performed using the inverse variance method. RESULTS: Seven prospective non-randomized and 4 retrospective studies, including a total of 1783 patients presenting 70 EMs, were considered for the quantitative analysis. The pooled rate of EM was 4% (95% CI, 2%-7%; range, 0.2%-11%; I2=82%); pooled morbidity rate was 31% (95% CI, 12%-59%; range, 0%-100%; I2=64%) and pooled reintervention rate was 32% (95% CI, 15%-56%; range, 0%-100%; I2=55%). The pooled mortality rate due to EM was 5% (95% CI, 1%-21%; range, 0%-40%; I2=24%). CONCLUSION: For the first time, this meta-analysis provides pooled reference estimates of EM after TEVAR. Thus, the results hold the potential to further characterize EM after TEVAR. The clinical relevance of EM is underlined by its association with high rates of endoleak-related morbidity, reintervention, and mortality. Close standardized surveillance after TEVAR for early detection of EM and prophylaxis of its sequelae is essential.
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Skrypnik et al. (2022) conducted a meta-analysis in Thoracic endovascular aortic repair (TEVAR) (n=1,783). Thoracic endovascular aortic repair (TEVAR) was evaluated on Endograft migration (EM) (95% CI 2%-7%). Following thoracic endovascular aortic repair, the pooled rate of endograft migration was 4% (95% CI, 2%-7%), with associated pooled morbidity of 31% and mortality of 5%.
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