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Stent graft types for endovascular repair of thoracic aortic aneurysms
Rachel Rolph1, James M N Duffy, Matthew Waltham
1Department of Plastic and Reconstructive Surgery, Guys and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, UK, SE1 7EH.
Insights
This review found no studies comparing stent graft types for thoracic endovascular aneurysm repair. High-quality randomized controlled trials are needed to evaluate different stent graft designs for thoracic aortic aneurysms.
Area of Science:
- Vascular Surgery
- Medical Device Technology
- Evidence-Based Medicine
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.
- Numerous stent graft designs are now available for clinical use.
Purpose of the Study:
- To assess the different stent graft types used for endovascular repair of thoracic aortic aneurysms.
Main Methods:
- A systematic search of multiple trial registers and databases was conducted.
- The review included published and unpublished randomized controlled trials (RCTs).
- Data collection and analysis followed the Cochrane Handbook for Systematic Reviews of Interventions.
Main Results:
- No studies met the inclusion criteria for the review.
- The absence of eligible studies precluded any assessment of evidence quality.
Conclusions:
- There is a lack of direct comparative data on the performance of various stent graft types.
- High-quality RCTs are essential to evaluate stent graft efficacy 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. This is an update of the review first published in 2013.
Objectives:
This review aimed to assess the different stent graft types for endovascular repair of thoracic aortic aneurysms.
Search Methods:
The Cochrane Vascular Group Trials Search Co-ordinator (TSC) searched the Specialised Register (last searched February 2015) and the Cochrane Register of Studies CENTRAL (2015, Issue 1). 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. It was not possible to assess the quality of the evidence in the absence of studies eligible for inclusion in the review.
Authors' Conclusions:
Unfortunately, no data exist regarding direct comparisons of the performance of different stent graft types. High quality RCTs evaluating stent graft types in thoracic endovascular aneurysm repair are required.
