Objective: To compare the risk of mortality and complications between male and female patients undergoing aortic aneurysm repair with fenestrated-branched endovascular aortic repair (FBEVAR).
Methods: The PubMed, Embase, and Scopus databases were searched systematically for observational studies in patients undergoing elective fenestrated branched endovascular repair for aortic aneurysm. The included studies compared outcomes of interest based on the sex of the patients. The pooled effect sizes were reported as odds ratio (OR) and weighted mean difference (WMD). STATA software was used for statistical analysis.
Results: The meta-analysis included nine studies. Compared with males, females had a higher risk of perioperative and in-hospital mortality (OR, 3.01; 95% confidence interval [CI], 2.01-4.53), mortality within 1 year postoperatively (OR, 1.79; 95% CI, 1.09-2.93) and mortality at more than 1 year postoperatively (OR, 1.31l 95% CI, 1.02-1.69). Female patients had significantly higher operative time (minutes) (WMD, 33.77; 95% CI, 12.01-55.52), length of hospital stay (days) (WMD, 2.29; 95% CI, 1.52-3.07), and the risk of major complications (OR, 2.93; 95% CI, 1.36-6.32) There was an increased risk of respiratory complications (OR, 1.70; 95% CI, 1.20-2.40), renal complications (OR, 2.68; 95% CI, 1.25-5.74), stroke (OR, 2.74; 95% CI, 1.44-5.22), sepsis (OR, 2.24; 95% CI, 1.23-4.09), and ischemic colitis (OR, 2.63; 95% CI, 1.48-4.68) in female patients, and they were less likely to be discharged home postoperatively (OR, 0.58; 95% CI, 0.43-0.77).
Conclusions: In patients undergoing FBEVAR, female sex is associated with higher risk of mortality and complications. These findings suggest the need for careful supervision and management by multidisciplinary team in females undergoing FBEVAR.
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http://dx.doi.org/10.1016/j.jvs.2022.10.029 | DOI Listing |
Forensic Sci Med Pathol
January 2025
Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Via S. Pansini, 5, Naples, 80131, Italy.
The dissection of the aorta is a serious and potentially fatal consequence of cocaine use. Nonetheless, the underlying mechanisms and characteristics of this phenomenon remain to be deeply studied. The autopsy case of a 46-year-old white male found irresponsive and unconscious in his house and had a history of abusing cocaine is presented.
View Article and Find Full Text PDFJCI Insight
January 2025
Section of Vascular Surgery, Department of Surgery, and.
Abdominal aortic aneurysms (AAA) are a life-threatening cardiovascular disease for which there is a lack of effective therapy preventing aortic rupture. During AAA formation, pathological vascular remodeling is driven by vascular smooth muscle cell (VSMC) dysfunction and apoptosis, for which the mechanisms regulating loss of VSMCs within the aortic wall remain poorly defined. Using single-cell RNA-Seq of human AAA tissues, we identified increased activation of the endoplasmic reticulum stress response pathway, PERK/eIF2α/ATF4, in aortic VSMCs resulting in upregulation of an apoptotic cellular response.
View Article and Find Full Text PDFAnn Surg
January 2025
Hubei Key Laboratory of Ischemic Cardiovascular Disease, Yichang, China.
Objective: The aim of this study is to explore the risk profiles associated with Abdominal aortic aneurysm (AAA) incidence in both the general population and diverse subpopulations.
Summary Background Data: AAA is a life-threatening arterial disease, and there is limited understanding of its etiological spectrum across the age, sex, and genetic risk subgroups, making early prevention efforts more complicated.
Methods: This study encompassed a sample size of 364399 participants from the UK.
J Vasc Surg Cases Innov Tech
April 2025
Department of Radiology and Nuclear Medicine, University Teaching and Research Hospital Lucerne, Luzern, Switzerland.
Objective: The aim of this single-center case series is to demonstrate that an ultra-low dose (ULD) can be routinely achieved in the hybrid operating room in standard endovascular aortic repair (EVAR) for infrarenal abdominal aortic aneurysm by adjusting the manufacturer's predefined imaging parameters, hardware configurations and user protocols (including benchmarking).
Methods: The hybrid operating room manufacturer predefined EVAR software setup of the dose exposure control software (OPTIQ, Siemens Healthineers, Forchheim, Germany) at our university medical center was screened for possible improvements regarding radiation dose application. Tests on a water-equivalent as well as polymethyl methacrylate phantom model to assess the impact of technical settings were performed, including comparison of settings for exposure control software, different magnification, collimation configurations and detector distance.
Nat Cardiovasc Res
January 2025
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