Key result
E-vita hybrid stent grafts suggested lower 30-day mortality, permanent neurological deficit, and one-year mortality compared to Thoraflex™ in thoracic aortic aneurysm surgery.
Why the study?
The rate of morbidity and mortality associated with the use of E-vita hybrid stent graft versus Thoraflex in patients undergoing complex aortic surgery needed systematic evaluation.
Does the E-vita hybrid stent graft reduce morbidity and mortality compared to the Thoraflex prosthesis in patients undergoing thoracic aortic aneurysm surgery?
Meta-Analysis (n=2,161)
Does the E-vita hybrid stent graft reduce morbidity and mortality compared to the Thoraflex prosthesis in patients undergoing thoracic aortic aneurysm surgery?
The E-vita hybrid stent graft may be associated with lower short-term mortality and neurological morbidity compared to the Thoraflex device in thoracic aortic aneurysm surgery, though direct comparisons are limited by study heterogeneity.
E-vita may be associated with lower short-term mortality and neurological risk than Thoraflex; leaves open need for direct comparative trials.
Objective: To systematically review the rate of morbidity and mortality associated with the use of E-vita hybrid stent graft and ThoraflexTM in patients undergoing complex aortic surgery. Methods: A comprehensive search was undertaken among the four major databases to identify published data about E-vita or Thoraflex™ in patients undergoing repair of thoracic aortic aneurysms. Results: In total, 28 papers were included in the study, encompassing a total of 2,161 patients (1,919 E-vita and 242 Thoraflex™). Patients undergoing surgery with E-vita or Thoraflex™ were of similar age and sex. The number of patients undergoing non-elective repair with Thoraflex™ was higher than with E-vita (35.2% vs. 28.7%, respectively). Cardiopulmonary bypass time was associated with increasing mortality in E-vita patients, however a meta-analysis of proportions showed higher 30-day mortality, permanent neurological deficit, and one-year mortality for Thoraflex™ patients. Direct statistical comparisons between E-vita and Thoraflex™ was not possible due to heterogeneity of studies. Conclusion: Although there are limited studies available, the available data suggests that mortality and morbidity are lower for the E-vita device in thoracic aortic aneurysm surgery than for Thoraflex™. Long-term data of comparative studies do not yet exist to assess viability of these procedures.
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Harky et al. (2020) conducted a meta-analysis in Thoracic aortic aneurysms (n=2,161). E-vita OPEN PLUS Hybrid Stent Graft vs. Thoraflex™ Hybrid Prosthesis was evaluated on 30-day mortality, permanent neurological deficit, and one-year mortality. E-vita hybrid stent grafts suggested lower 30-day mortality, permanent neurological deficit, and one-year mortality compared to Thoraflex™ in thoracic aortic aneurysm surgery.
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