VASA. Zeitschrift für Gefässkrankheiten
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Review Meta Analysis
Loco-regional versus general anaesthesia for elective endovascular aneurysm repair - results of a cohort study and a meta-analysis.
The aim of this study was to investigate whether patients undergoing elective endovascular aneurysm repair (EVAR) with loco-regional anaesthetic techniques have better outcomes than those treated with general anaesthesia (GA). ⋯ Local and/or regional anaesthetic techniques may be advantageous over GA in elective EVAR, as indicated by reduced perioperative mortality and morbidity and a shorter hospital stay. Considering the current level of evidence, LA or RA should be considered in selected patients. Further clinical research is required to provide high level evidence on the optimal anaesthetic technique in EVAR.
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Review Meta Analysis
Direct oral factor Xa inhibitors for the prevention of non-central nervous systemic embolism patients with non-valvular atrial fibrillation - a systematic review and meta-analysis.
The aim of this systematic review and meta-analysis was to evaluate the efficacy of direct oral factor Xa inhibitors for preventing non-central nervous systemic embolism in patients with non-valvular atrial fibrillation. ⋯ As a drug class, direct oral factor Xa inhibitors do not reduce the incidence of non-central nervous systemic embolism (or ischaemic stroke) in patients with non-valvular atrial fibrillation. Selecting drugs for the prevention of non-central nervous systemic embolism in patients with non-valvular atrial fibrillation should be based on individual drug efficacy data, rather than class data.
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Review Meta Analysis
Catheter-directed thrombolysis plus anticoagulation versus anticoagulation alone in the treatment of proximal deep vein thrombosis - a meta-analysis.
The aim of this meta-analysis was to compare the clinical outcomes of catheter-directed thrombolysis (CDT) plus anticoagulation with anticoagulation alone in patients with lower-extremity proximal deep vein thrombosis (DVT). ⋯ Additional CDT therapy appeared to be more effective than standard anticoagulation treatment in improving the venous patency and preventing venous obstruction and postthrombotic syndrome. Caution should be taken when performing CDT given the increased risk of major bleeding. However, no evidence supported benefits of CDT in reducing mortality, recurrent DVT, or pulmonary embolism.
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Patients with intermittent claudication suffer from pain in the muscles of the legs during exercise that is relieved by a short rest. Ginkgo biloba extract is a vasoactive agent used for symptomatic relief in intermittent claudication. In this article a meta-analysis is discussed that assessed the effect of Ginkgo biloba on walking capacity in patients with intermittent claudication. ⋯ There is no evidence that Ginkgo biloba has a clinically significant benefit for patients with intermittent claudication.