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April 18, 2014European Journal of Vascular and Endovascular SurgeryOpen Access

Editor's Choice – Endovascular Aneurysm Repair Versus Open Repair for Patients with a Ruptured Abdominal Aortic Aneurysm: A Systematic Review and Meta-analysis of Short-term Survival

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Key result

Endovascular aneurysm repair is not inferior to open repair for short-term survival in patients with a ruptured abdominal aortic aneurysm (pooled OR for death from RCTs 0.90; 95% CI 0.65-1.24).

Why the study?

Does endovascular aneurysm repair reduce short-term mortality compared to open repair in patients with a ruptured abdominal aortic aneurysm?

Population

Patients with a ruptured abdominal aortic aneurysm from 3 RCTs, 21 observational studies, and 8…

Comparison

Endovascular aneurysm repair (EVAR) vs Open repair (OR)

Design

Meta-analysis

Follow-up

30-day or in-hospital

Authors

SBS.C. van BeekACA.P. ConijnMKMark J.W. Koelemay

Discussion

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Member takes

Overview

Supports EVAR in suitable rAAA patients; confirms noninferior short-term survival versus open repair in RCT meta-analysis.

Study Design

Type

Meta-Analysis

Structured PICO

Does endovascular aneurysm repair reduce short-term mortality compared to open repair in patients with a ruptured abdominal aortic aneurysm?

P
Population
Systematic review and meta-analysis of 3 RCTs, 21 observational studies, and 8 administrative registries comparing EVAR and open repair for ruptured abdominal aortic aneurysm.
I
Intervention
Endovascular aneurysm repair (EVAR)
C
Comparator
Open repair (OR)
O
Outcome
Short-term (combined 30-day or in-hospital) survival/deathhard clinical

Main Result

Odds Ratio: 0.9 (95% CI 0.65–1.24)

Endovascular aneurysm repair is not inferior to open repair for short-term survival in patients with ruptured abdominal aortic aneurysm, supporting its use in suitable patients.

Limitations

  • The majority of the observational studies had a high risk of bias
  • The majority of the administrative registries had a high risk of bias
  • High risk of bias in the majority of observational studies
  • High risk of bias in the majority of administrative registries

Cite This Study

Beek et al. (2014) conducted a meta-analysis in Ruptured abdominal aortic aneurysm (RAAA). Endovascular aneurysm repair (EVAR) vs. Open repair (OR) was evaluated on Short-term (combined 30-day or in-hospital) death (OR 0.90, 95% CI 0.65-1.24). Endovascular aneurysm repair is not inferior to open repair for short-term survival in patients with a ruptured abdominal aortic aneurysm (pooled OR for death from RCTs 0.90; 95% CI 0.65-1.24).

synapsesocial.com/papers/6a976ef2da663e44ef76e6dehttps://doi.org/10.1016/j.ejvs.2014.03.003
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