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Stent graft types for endovascular repair of thoracic aortic aneurysms
Rachel Rolph1, James M N Duffy, Bijan Modarai
1Academic Vascular Department, Guy’s and St Thomas’ NHS Foundation Trust, London, UK.
Insights
This review found no studies comparing stent graft types for thoracic endovascular aneurysm repair. More high-quality trials are needed to guide clinical selection of these devices.
Area of Science:
- Vascular Surgery
- Medical Device Technology
- Systematic Review Methodology
Background:
- Thoracic aortic aneurysms affect 10.4 per 100,000 person-years in the UK.
- Endovascular repair using stent grafts is increasingly popular for thoracic aortic aneurysms.
- Multiple stent graft designs are commercially available for thoracic endovascular aneurysm repair.
Purpose of the Study:
- To assess different stent graft types for endovascular repair of thoracic aortic aneurysms.
- To identify comparative data on the performance of various stent graft systems.
Main Methods:
- Conducted a systematic search of multiple databases (Cochrane Peripheral Vascular Diseases Group, CENTRAL) up to November 2012.
- Included published and unpublished randomized controlled trials (RCTs) without language restriction.
- Followed Cochrane Handbook guidelines for data collection and analysis.
Main Results:
- No randomized controlled trials met the inclusion criteria for the review.
- No studies were identified that directly compared different stent graft types for thoracic endovascular aneurysm repair.
Conclusions:
- There is a lack of comparative data on the performance of various stent graft types.
- The review cannot provide guidance to clinicians on selecting stent graft types.
- High-quality RCTs are required to evaluate stent graft types in thoracic endovascular aneurysm repair.
Background:
The UK prevalence of thoracic aneurysm is estimated at 10.4 per 100,000 person-years. Progressive and unpredictable enlargement can lead to rupture. Endovascular repair of thoracic aortic aneurysms involves a stent graft system being introduced via the femoral artery and manipulated within the aorta under radiological guidance. Following endograft deployment, a seal is formed at the proximal and distal landing zones to exclude the aneurysm sac from the circulation. With the increasing popularity of endovascular repair there has been an increase in the number of commercially available stent graft designs on the market.
Objectives:
This review aimed to assess the different stent graft types for endovascular repair of thoracic aortic aneurysms.
Search Methods:
The Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator (TSC) searched the Specialised Register (last searched November 2012) and CENTRAL (2012, Issue 11). Trial databases were searched by the TSC for details of ongoing and unpublished studies.
Selection Criteria:
All published and unpublished randomised controlled trials (RCTs) of stent graft types in the repair of thoracic aortic aneurysms were sought without language restriction.
Data Collection And Analysis:
Data collection and analysis was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions.
Main Results:
No studies were identified that met the inclusion criteria.
Authors' Conclusions:
Unfortunately, no data exist regarding direct comparisons of the performance of different stent graft types. Therefore, this review cannot recommend guidance to clinicians in their selection of stent graft types. High quality RCTs evaluating stent graft types in thoracic endovascular aneurysm repair are required.
