D'Souza, Rovan Evan;
Girish, Girish;
D'Souza, Preethy;
Lewis, Melissa Glenda;
Renjith, Vishnu;
(2022)
Outcomes of Visceral Arterial Reconstruction: A Systematic Review.
Vascular and Endovascular Surgery
, 56
(3)
pp. 290-297.
10.1177/15385744211029112.
Preview |
Text
D'Souza_Revised Manuscript VES.pdf Download (876kB) | Preview |
Abstract
Aims: The study aimed to review the use of synthetic grafts (SGs) and autologous vein grafts (AVGs) in visceral arterial reconstruction (VAR) in chronic visceral ischaemia. Methods: Systematic review methodology was employed. Results: Six studies were included (218 patients and 281 vessels). Two studies had data about AVG only, 3 had data about SG only and 1 had both AVG and SG data. Three studies reported outcomes for AVG (117 patients and 132 vessels revascularized). One-year primary patency was 87% (95% CI 71%, 97%). Graft thrombosis rate was 6% (95% CI 0%, 16%). Pooled stenosis rate at one-year was 11% (95% CI 1%, 28%). The 30-day (n = 96), one-year (n = 72) and 5-year mortality (n = 30) were 0%, 0% and 12%, respectively. Four studies reported outcomes for SGs (106 patients and 147 vessels). The pooled primary patency at one year was 100% (95% CI 99%, 100%). Pooled primary 5-year patency rate was 88% (95% CI 69%, 100%). There was no graft infection in 2 of the 3 studies. Overall pooled percentage of graft thrombosis and stenosis at one year was 0%. Jimenez et al. (2002) reported one graft thrombosis at 20 months and graft stenosis in 2 patients at 46 and 49 months. Illuminati et al (2017) reported graft thrombosis in 2/24 patients at 22 and 52 months. Thirty days, one-year and 5-year mortality was 1% (95% CI 0%, 6), 7% (95% CI 0%, 20%) and 39% (95% CI 11%), respectively. Conclusion: Patency was better with SG compared with AVG. Mortality was higher in the SG group. Graft dilatation does occur with vein grafts, but in this review no intervention was found necessary. Poorly designed studies, incomplete reporting and absence of morbidity and mortality indices preclude emphatic conclusions.
| Type: | Article |
|---|---|
| Title: | Outcomes of Visceral Arterial Reconstruction: A Systematic Review |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/15385744211029112 |
| Publisher version: | https://doi.org/10.1177/15385744211029112 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Surgery, Peripheral Vascular Disease, Cardiovascular System & Cardiology, chronic mesenteric ischaemia, chronic visceral ischaemia, visceral arterial reconstruction, mesenteric artery ischaemia, renal artery stenosis, renal artery obstruction, superior mesenteric artery, coeliac artery, systematic review, CHRONIC-MESENTERIC-ISCHEMIA, VEIN GRAFT ANEURYSMS, SAPHENOUS-VEIN, AORTORENAL BYPASS, REVASCULARIZATION, MANAGEMENT |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute UCL > Provost and Vice Provost Offices > School of Education UCL |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10153246 |
Archive Staff Only
 |
View Item |
