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CardioVascular and Interventional Radiology

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01-12-2015 | Clinical Investigation

The Impact of Aortic Occlusion Balloon on Mortality After Endovascular Repair of Ruptured Abdominal Aortic Aneurysms: A Meta-analysis and Meta-regression Analysis

Authors: Christos D. Karkos, Christina T. Papadimitriou, Theodoros N. Chatzivasileiadis, Nikoletta S. Kapsali, Thomas E. Kalogirou, Ioakeim T. Giagtzidis, Konstantinos O. Papazoglou

Published in: CardioVascular and Interventional Radiology | Issue 6/2015

Abstract

Introduction

We aimed to investigate whether the use of aortic occlusion balloon (AOB) has an impact on mortality of patients undergoing endovascular repair of ruptured abdominal aortic aneurysms (RAAAs).

Methods

A meta-analysis of the English-language literature was undertaken through February 2013. Articles reporting data on outcome after endovascular repair of RAAAs were identified and information regarding the use of AOB was sought.

Results

Included in this meta-analysis were 39 eligible studies reporting 1277 patients. The pooled perioperative mortality was 21.6 % (95 % CI 18.1–25.1 %). There was significant within-study heterogeneity (I ² 50.2 %, P < 0.001). A total of 200 patients required AOB with an estimated pooled proportion of 14.1 % (8.9–19.3 %). Individual random-effects meta-regression investigating the effect of AOB and other risk factors on mortality revealed a significant linear association of hemodynamic instability, bifurcated endograft approach, and primary conversion to open repair with mortality and a nonlinear (second degree polynomial) association of AOB with mortality. On multivariable meta-regression models, both hemodynamic instability and AOB were found to be statistically significant, independent predictors of mortality. In particular, there was a statistically significant negative correlation between AOB and mortality and a positive effect of hemodynamic instability on mortality. In practical terms, mortality was significantly higher in studies with a higher proportion of hemodynamically unstable patients and lower in studies with a higher rate of AOB use.

Conclusion

This study provides meta-analytical evidence that the use of an AOB in unstable RAAA patients undergoing endovascular repair may improve the results.

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Title: The Impact of Aortic Occlusion Balloon on Mortality After Endovascular Repair of Ruptured Abdominal Aortic Aneurysms: A Meta-analysis and Meta-regression Analysis
Authors: Christos D. Karkos
Christina T. Papadimitriou
Theodoros N. Chatzivasileiadis
Nikoletta S. Kapsali
Thomas E. Kalogirou
Ioakeim T. Giagtzidis
Konstantinos O. Papazoglou
Publication date: 01-12-2015
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 6/2015
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-015-1132-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The Impact of Aortic Occlusion Balloon on Mortality After Endovascular Repair of Ruptured Abdominal Aortic Aneurysms: A Meta-analysis and Meta-regression Analysis

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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