Meta-analysis of the efficacy and safety of stent-graft endovascular repair for Stanford type B aortic dis-section
Wei Ziqiong
Jia Jingjing
Wang Honglei
Abstract：Objective To systematically evaluate the therapeutic effect and safety of stent-graft endovascular repair for Stanford type B aortic dissection(TBAD)using Meta-analysis.Methods Systematic retrieval of Chinese and English databases,including CNKI,Wanfang Database,VIP,CBM,PubMed,Embase,the Cochrane Library and Web of Science,to collect randomized controlled trials(RCTs)of endovascular stent-graft repair for TBAD,with the retrieval time from inception to October 31,2023.Quality assessment and data extraction were performed on the included literature,Stata 16.0 and RevMan 5.4 software were used to conduct meta-analysis on various outcome indicators.Results A meta-analysis of 13 RCTs was conducted,including 1114 patients with TBAD,of whom 575 underwent endovascular repair with covered stent.The meta-analysis results showed that the trial group that received endovascular repair with covered stent had significantly improved survival rate(OR=6.51,95％CI:3.50～12.11,P＜0.01),reoperation or intervention rate(OR=0.33,95％CI:0.21～0.52,P＜0.01),aspartate aminotransferase(MD=-23.02 U/L,95％CI:-25.01～-21.03,P＜0.01),alanine aminotransferase(MD=-14.28 U/L,95％CI:-15.58～-12.99,P＜0.01),blood urea nitrogen(MD=-1.35 mmol/L,95％CI:-1.63～-1.06,P＜0.01)and creatinine(MD=-23.43 mmol/L,95％CI:-26.30～-20.57,P＜0.01)compared with the control group.The incidence of endoleak(OR=6.11,95％CI:0.73～51.34,P=0.10)and vascular occlusion(OR=3.00,95％CI:0.31～29.16,P=0.34)in the TBAD patients of the experimental group had no statistically significant difference with the control group;the incidence of cerebral infarction(OR=0.14,95％CI:0.03～0.65,P=0.01),liver and kidney dysfunction(OR=0.22,95％CI:0.07～0.74,P=0.01)and total complications(OR=0.30,95％CI:0.17～0.54,P＜0.01)in the experimental group were lower than the control group,and the difference between groups was statistically significant.Conclusion The stent-graft endovascular repair can effectively improve the survival rate of TBAD patients and reduce the rate of reoperation or intervention.It has better safety regarding overall complications,but more high-quality literature is needed to verify its effects on specific complications further.
Keywords：Stanford type B aortic dissectionStent-graft endovascular repairEfficacySafetyMeta-analysis
Publication Date：2024-11-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1295-1299 )