Thoracic stent graft versus surgery for thoracic aneurysm

Area of Science:

• Vascular Surgery
• Cardiovascular Research
• Medical Technology Assessment

Background:

• Thoracic aortic aneurysm (TAA) is a rare condition with unpredictable enlargement, potentially leading to rupture.
• Conventional open chest surgical repair carries significant perioperative risks.
• Thoracic endovascular aneurysm repair (TEVAR) offers a less invasive alternative, but requires robust evidence.

Purpose of the Study:

• To assess the efficacy of TEVAR compared to conventional open surgery for thoracic aortic aneurysms.
• To update previous reviews on the comparative effectiveness of these TAA treatments.

Main Methods:

• Systematic search of specialized databases (Cochrane Vascular, CENTRAL) up to January 2016.
• Inclusion criteria: Randomized controlled trials comparing TEVAR and open surgical repair for TAAs.
• Independent review of eligible trials by two authors; exclusion checks by a third author.

Main Results:

• No published or unpublished randomized controlled trials were identified for this review.
• Statistical analyses were not performed due to the absence of eligible randomized controlled trials.

Conclusions:

• While stent grafting for thoracic aorta is feasible and non-randomized studies suggest benefits, high-quality randomized controlled trials are essential.
• Further research should evaluate clinically relevant outcomes including conversion, exclusion, endoleaks, and long-term mortality.