Endovascular versus Open Surgical Repair for Isolated Ruptured Descending Thoracic Aorta: A Systematic Review and Meta-Analysis

Amer Harky, Francesca Gatta Da

Abstract

The purpose of this study was to compare clinical outcomes between open and thoracic endovascular aortic repair (TEVAR) in isolated ruptured descending thoracic aorta. Methods: A comprehensive electronic search was undertaken to identify all published data comparing open versus endovascular repair in ruptured descending thoracic aorta. Databases where evaluated to March 2018. Results: A total of 29,133 patients were analysed in 19 articles. Mean age was similar in both group of patients (54.6±12.8 yrs vs 54.6±13.5 yrs, p=0.19). Shorter ICU and total hospital stay in TEVAR (6.9±5.9 vs 9.1±6.6 days, p=0.003 and 16.5±8.9 vs 19.8±10 days, p=0.009 respectively). Paraplegia and stroke were higher in TEVAR with no statistical significance (2.5% vs 1.6%, p=0.47, and 1.7% vs 0.84%, p=0.62 respectively). There was also higher rate of re-intervention at one year in the TEVAR (p=0.001). While, a lower in-hospital mortality noted in TEVAR (6.5% vs 10.2% respectively, p=0.003), but no statistical difference in mortality rates at one and five years (p=0.51 and p=0.33 respectively).

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