PMID- 26040254
OWN - NLM
STAT- MEDLINE
DCOM- 20160902
LR  - 20151120
IS  - 1432-086X (Electronic)
IS  - 0174-1551 (Linking)
VI  - 38
IP  - 6
DP  - 2015 Dec
TI  - The Impact of Aortic Occlusion Balloon on Mortality After Endovascular Repair of 
      Ruptured Abdominal Aortic Aneurysms: A Meta-analysis and Meta-regression 
      Analysis.
PG  - 1425-37
LID - 10.1007/s00270-015-1132-1 [doi]
AB  - INTRODUCTION: We aimed to investigate whether the use of aortic occlusion balloon 
      (AOB) has an impact on mortality of patients undergoing endovascular repair of 
      ruptured abdominal aortic aneurysms (RAAAs). METHODS: A meta-analysis of the 
      English-language literature was undertaken through February 2013. Articles 
      reporting data on outcome after endovascular repair of RAAAs were identified and 
      information regarding the use of AOB was sought. RESULTS: Included in this 
      meta-analysis were 39 eligible studies reporting 1277 patients. The pooled 
      perioperative mortality was 21.6% (95% CI 18.1-25.1%). There was significant 
      within-study heterogeneity (I(2) 50.2%, P < 0.001). A total of 200 patients 
      required AOB with an estimated pooled proportion of 14.1% (8.9-19.3%). Individual 
      random-effects meta-regression investigating the effect of AOB and other risk 
      factors on mortality revealed a significant linear association of hemodynamic 
      instability, bifurcated endograft approach, and primary conversion to open repair 
      with mortality and a nonlinear (second degree polynomial) association of AOB with 
      mortality. On multivariable meta-regression models, both hemodynamic instability 
      and AOB were found to be statistically significant, independent predictors of 
      mortality. In particular, there was a statistically significant negative 
      correlation between AOB and mortality and a positive effect of hemodynamic 
      instability on mortality. In practical terms, mortality was significantly higher 
      in studies with a higher proportion of hemodynamically unstable patients and 
      lower in studies with a higher rate of AOB use. CONCLUSION: This study provides 
      meta-analytical evidence that the use of an AOB in unstable RAAA patients 
      undergoing endovascular repair may improve the results.
FAU - Karkos, Christos D
AU  - Karkos CD
AD  - 5th Department of Surgery, Medical School, Aristotle University of Thessaloniki, 
      Hippocratio Hospital, Konstantinoupoleos 49, 546 42, Thessaloniki, Greece. 
      ckarkos@hotmail.com.
FAU - Papadimitriou, Christina T
AU  - Papadimitriou CT
AD  - 5th Department of Surgery, Medical School, Aristotle University of Thessaloniki, 
      Hippocratio Hospital, Konstantinoupoleos 49, 546 42, Thessaloniki, Greece.
FAU - Chatzivasileiadis, Theodoros N
AU  - Chatzivasileiadis TN
AD  - Institute for Environmental Studies, Vrije Universiteit Amsterdam, Amsterdam, The 
      Netherlands.
FAU - Kapsali, Nikoletta S
AU  - Kapsali NS
AD  - Health Economist/Statistical Programmer, Erasmus Universiteit Rotterdam, 
      Rotterdam, The Netherlands.
FAU - Kalogirou, Thomas E
AU  - Kalogirou TE
AD  - 5th Department of Surgery, Medical School, Aristotle University of Thessaloniki, 
      Hippocratio Hospital, Konstantinoupoleos 49, 546 42, Thessaloniki, Greece.
FAU - Giagtzidis, Ioakeim T
AU  - Giagtzidis IT
AD  - 5th Department of Surgery, Medical School, Aristotle University of Thessaloniki, 
      Hippocratio Hospital, Konstantinoupoleos 49, 546 42, Thessaloniki, Greece.
FAU - Papazoglou, Konstantinos O
AU  - Papazoglou KO
AD  - 5th Department of Surgery, Medical School, Aristotle University of Thessaloniki, 
      Hippocratio Hospital, Konstantinoupoleos 49, 546 42, Thessaloniki, Greece.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20150604
PL  - United States
TA  - Cardiovasc Intervent Radiol
JT  - Cardiovascular and interventional radiology
JID - 8003538
SB  - IM
MH  - Aortic Aneurysm, Abdominal/*therapy
MH  - Aortic Rupture/*therapy
MH  - *Balloon Occlusion
MH  - *Endovascular Procedures
MH  - Humans
MH  - Risk Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Abdominal aortic aneurysms (AAA)
OT  - Acute aortic syndrome
OT  - Aorta
OT  - Arterial intervention
OT  - Endovascular aneurysm
OT  - Repair/endovascular aortic repair (EVAR)
EDAT- 2015/06/05 06:00
MHDA- 2016/09/03 06:00
CRDT- 2015/06/05 06:00
PHST- 2014/11/15 00:00 [received]
PHST- 2015/04/15 00:00 [accepted]
PHST- 2015/06/05 06:00 [entrez]
PHST- 2015/06/05 06:00 [pubmed]
PHST- 2016/09/03 06:00 [medline]
AID - 10.1007/s00270-015-1132-1 [pii]
AID - 10.1007/s00270-015-1132-1 [doi]
PST - ppublish
SO  - Cardiovasc Intervent Radiol. 2015 Dec;38(6):1425-37. doi: 
      10.1007/s00270-015-1132-1. Epub 2015 Jun 4.