Annals of vascular surgery
-
Review Meta Analysis
The influence of study design on the evaluation of ruptured abdominal aortic aneurysm treatment.
The best strategy in the treatment for ruptured abdominal aortic aneurysm (RAAA) is an ongoing matter of debate. Differently from several retrospective studies, recent randomized controlled trials (RCTs) failed to demonstrate the superiority of endovascular repair (EVAR) over open repair (OPEN). The aim of the present study was to compare 30-day mortality of EVAR and OPEN in RAAA according to different study designs through a systematic review and meta-analysis. ⋯ Only few studies are available to compare EVAR and OPEN in an "unbiased" cohort, with no significant differences between the 2 treatments. However, after the introduction of EVAR and OPEN protocols, the overall mortality for RAAA was reduced compared with the only OPEN option, suggesting a beneficial effect of EVAR in selected cases.
-
Review Meta Analysis
Fenestrated endovascular repair for pararenal abdominal aortic aneurysms: a systematic review and meta-analysis.
The development of endovascular technology has led to the introduction of fenestrated endovascular repair (f-EVAR) to treat pararenal abdominal aortic aneurysms (PRAAAs) that have been deemed unsuitable for standard endovascular repair. We performed a systematic review and meta-analysis of data from the literature to determine the outcomes of the fenestrated technology. ⋯ This study revealed that f-EVAR treatment for PRAAAs has acceptable early and mid-term outcomes.
-
Review Meta Analysis
Systematic review of randomized controlled trials of new anticoagulants for venous thromboembolism prophylaxis in major orthopedic surgeries, compared with enoxaparin.
In the past 10 years, new anticoagulants (NACs) have been studied for venous thromboembolism (VTE) prophylaxis. ⋯ NACs can be considered alternatives to conventional thromboprophylaxis regimens in patients undergoing elective major orthopedic surgery, depending on clinical characteristics and cost-effectiveness. The knowledge of some differences concerning efficacy or safety profile, pointed out in this systematic review, along with the respective limitations, may be useful in clinical practice.
-
Review Meta Analysis
Updated systematic review and meta-analysis of randomized clinical trials comparing carotid artery stenting and carotid endarterectomy in the treatment of carotid stenosis.
To compare carotid artery stenting (CAS) versus carotid endarterectomy (CEA) in the treatment of carotid stenosis, including two recently published, large, prospective, randomized trials of these therapies. ⋯ CAS is inferior to CEA with regard to the incidence of stroke or death for periprocedural outcomes, especially in symptomatic patients. However, CAS was associated with a lower incidence of myocardial infarction. These procedures may be considered complementary rather than competing modes of therapy, each of which can be optimized with careful patient selection.