Safety and Effectiveness of Open and Endovascular Repair for Inflammatory Abdominal Aortic Aneurysm: Systematic Review and Meta-Analysis

• Type: Another Publication in an International Scientific Journal
• Date: 2025

Authors

Finisterra Rodrigues, R (Author) Other; Pereira Neves, A (Author) Other; Dias Neto, M (Author) Other; Myrcha, P (Author) Other; Rocha Neves, J (Author) FMUP

Journal

Title: Annals of Vascular Surgery

Vol. 119

Pages: 130-144

ISSN: 0890-5096

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 0 Citations

Scopus - 1 Citation

Other information

Authenticus ID: P-018-RC4

DOI: 10.1016/j.avsg.2025.04.120

Abstract (EN): Background: Inflammatory abdominal aortic aneurysm (IAAA) is a rare subtype of atherosclerotic aneurysms with a pronounced inflammatory response and high risk of perioperative complications. The optimal treatment remains uncertain. This systematic-review with meta-analysis aims to evaluate mortality and perioperative complications in IAAA patients undergoing endovascular repair (EVAR) or open surgical repair (OSR). Methods: A systematic search of randomized controlled trials, nonrandomized interventional studies, case-controlled trials, cohorts, and case series studies was conducted in PubMed, SCOPUS, ISI Web of Science, and Cochrane databases. Mortality and complications were analyzed using binary common and random-effects models. Study quality was assessed with National Heart, Lung, and Blood Institute and Risk of Bias 2 tools. Results: Nineteen studies (656 patients) were included. The pooled estimate of 30-day mortality for EVAR was 2.9% (95% confidence interval [CI]: 0.4-6.1%; I-2-0%) and for OSR was slightly higher at 9% (95% CI: 5-15%; I-2-58%). Preoperative hydronephrosis was 12.7% (95% CI: 6.4-19.0%; I-2-0%) for EVAR and 16.5% (95% CI: 12.9-20.2%; I-2-0%) for OSR. Postoperative hydronephrosis was 9.8% (95% CI: 1.1-18.6%; I-2-0%) for EVAR and 6.1% (95% CI: 3.4-8.9%; I-2-0%) for OSR. Conclusion: OSR and EVAR are viable treatment options, with the choice guided by patient-specific factors. While OSR is more technically demanding and carries higher morbidity and mortality, it results in greater hydronephrosis resolution. EVAR, as a less invasive alternative, offers a safer perioperative profile but achieves less pronounced hydronephrosis reduction. Personalized surgical strategies and careful perioperative management are crucial.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 15