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Comparative Analysis of Morbidity and Mortality Outcomes in Elderly and Nonelderly Patients Undergoing Elective TEVAR: A Systematic Review and Meta-Analysis

Objective: Due to an ever-increasing ageing population and limited available data around the use of thoracic endovascular aortic repair (TEVAR) in elderly patients, investigating its efficacy and safety in this age cohort is of vital importance. We thus reviewed the existing literature on this topic...

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Autores principales: Frisiras, Angelos, Giannas, Emmanuel, Bobotis, Stergios, Kanella, Ilektra, Arjomandi Rad, Arian, Viviano, Alessandro, Spiliopoulos, Kyriakos, Magouliotis, Dimitrios E., Athanasiou, Thanos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10420243/
https://www.ncbi.nlm.nih.gov/pubmed/37568406
http://dx.doi.org/10.3390/jcm12155001
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author Frisiras, Angelos
Giannas, Emmanuel
Bobotis, Stergios
Kanella, Ilektra
Arjomandi Rad, Arian
Viviano, Alessandro
Spiliopoulos, Kyriakos
Magouliotis, Dimitrios E.
Athanasiou, Thanos
author_facet Frisiras, Angelos
Giannas, Emmanuel
Bobotis, Stergios
Kanella, Ilektra
Arjomandi Rad, Arian
Viviano, Alessandro
Spiliopoulos, Kyriakos
Magouliotis, Dimitrios E.
Athanasiou, Thanos
author_sort Frisiras, Angelos
collection PubMed
description Objective: Due to an ever-increasing ageing population and limited available data around the use of thoracic endovascular aortic repair (TEVAR) in elderly patients, investigating its efficacy and safety in this age cohort is of vital importance. We thus reviewed the existing literature on this topic to assess the feasibility of TEVAR in elderly patients with severe thoracic aortic pathologies. Methods: We identified all original research studies that assessed TEVAR in elderly patients published up to 2023. Morbidity, as assessed by neurological and respiratory complications, endoleaks, and length of stay, was the primary endpoint. Short-term mortality and long-term survival were the secondary endpoints. The Mantel–Haenszel random and fixed effects methods were used to calculate the odds ratios for each outcome. Further sensitivity and subgroup analyses were performed to validate the outcomes. Results: Twelve original studies that evaluated elective TEVAR outcomes in elderly patients were identified. Seven studies directly compared the use of TEVAR between an older and a younger patient group. Apart from a shorter hospital stay in older patients, no statistically significant difference between the morbidity outcomes of the two different cohorts was found. Short-term mortality and long-term survival results favoured the younger population. Conclusions: The present meta-analysis indicates that, due to a safe perioperative morbidity profile, TEVAR should not be contraindicated in patients based purely on old age. Further research using large patient registries to validate our findings in elderly patients with specific aortic pathologies and both elective and emergency procedures is necessary.
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spelling pubmed-104202432023-08-12 Comparative Analysis of Morbidity and Mortality Outcomes in Elderly and Nonelderly Patients Undergoing Elective TEVAR: A Systematic Review and Meta-Analysis Frisiras, Angelos Giannas, Emmanuel Bobotis, Stergios Kanella, Ilektra Arjomandi Rad, Arian Viviano, Alessandro Spiliopoulos, Kyriakos Magouliotis, Dimitrios E. Athanasiou, Thanos J Clin Med Systematic Review Objective: Due to an ever-increasing ageing population and limited available data around the use of thoracic endovascular aortic repair (TEVAR) in elderly patients, investigating its efficacy and safety in this age cohort is of vital importance. We thus reviewed the existing literature on this topic to assess the feasibility of TEVAR in elderly patients with severe thoracic aortic pathologies. Methods: We identified all original research studies that assessed TEVAR in elderly patients published up to 2023. Morbidity, as assessed by neurological and respiratory complications, endoleaks, and length of stay, was the primary endpoint. Short-term mortality and long-term survival were the secondary endpoints. The Mantel–Haenszel random and fixed effects methods were used to calculate the odds ratios for each outcome. Further sensitivity and subgroup analyses were performed to validate the outcomes. Results: Twelve original studies that evaluated elective TEVAR outcomes in elderly patients were identified. Seven studies directly compared the use of TEVAR between an older and a younger patient group. Apart from a shorter hospital stay in older patients, no statistically significant difference between the morbidity outcomes of the two different cohorts was found. Short-term mortality and long-term survival results favoured the younger population. Conclusions: The present meta-analysis indicates that, due to a safe perioperative morbidity profile, TEVAR should not be contraindicated in patients based purely on old age. Further research using large patient registries to validate our findings in elderly patients with specific aortic pathologies and both elective and emergency procedures is necessary. MDPI 2023-07-29 /pmc/articles/PMC10420243/ /pubmed/37568406 http://dx.doi.org/10.3390/jcm12155001 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Frisiras, Angelos
Giannas, Emmanuel
Bobotis, Stergios
Kanella, Ilektra
Arjomandi Rad, Arian
Viviano, Alessandro
Spiliopoulos, Kyriakos
Magouliotis, Dimitrios E.
Athanasiou, Thanos
Comparative Analysis of Morbidity and Mortality Outcomes in Elderly and Nonelderly Patients Undergoing Elective TEVAR: A Systematic Review and Meta-Analysis
title Comparative Analysis of Morbidity and Mortality Outcomes in Elderly and Nonelderly Patients Undergoing Elective TEVAR: A Systematic Review and Meta-Analysis
title_full Comparative Analysis of Morbidity and Mortality Outcomes in Elderly and Nonelderly Patients Undergoing Elective TEVAR: A Systematic Review and Meta-Analysis
title_fullStr Comparative Analysis of Morbidity and Mortality Outcomes in Elderly and Nonelderly Patients Undergoing Elective TEVAR: A Systematic Review and Meta-Analysis
title_full_unstemmed Comparative Analysis of Morbidity and Mortality Outcomes in Elderly and Nonelderly Patients Undergoing Elective TEVAR: A Systematic Review and Meta-Analysis
title_short Comparative Analysis of Morbidity and Mortality Outcomes in Elderly and Nonelderly Patients Undergoing Elective TEVAR: A Systematic Review and Meta-Analysis
title_sort comparative analysis of morbidity and mortality outcomes in elderly and nonelderly patients undergoing elective tevar: a systematic review and meta-analysis
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10420243/
https://www.ncbi.nlm.nih.gov/pubmed/37568406
http://dx.doi.org/10.3390/jcm12155001
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