Journal of vascular surgery
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Review Meta Analysis Comparative Study
Endovenous therapies of lower extremity varicosities: a meta-analysis.
Minimally invasive techniques such as endovenous laser therapy, radiofrequency ablation, and ultrasound-guided foam sclerotherapy are widely used in the treatment of lower extremity varicosities. These therapies have not yet been compared with surgical ligation and stripping in large randomized clinical trials. ⋯ In the absence of large, comparative randomized clinical trials, the minimally invasive techniques appear to be at least as effective as surgery in the treatment of lower extremity varicose veins.
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Review Meta Analysis
Meta-analysis of endovascular vs open repair for traumatic descending thoracic aortic rupture.
Traumatic thoracic aortic injuries are associated with high mortality and morbidity. These patients often have multiple injuries, and delayed aortic repair is frequently used. Endoluminal grafts offer an alternative to open surgical repair. We performed a meta-analysis of comparative studies evaluating endovascular vs open repair of these injuries. ⋯ Meta-analysis of retrospective cohort studies indicates that endovascular treatment of descending thoracic aortic trauma is an alternative to open repair and is associated with lower postoperative mortality and ischemic spinal cord complication rates.
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Review Meta Analysis
Open thoracic or thoracoabdominal aortic aneurysm repair after previous abdominal aortic aneurysm surgery.
The purpose of this study was to provide insight into the incidence of thoracic and thoracoabdominal aortic aneurysm repair following previous infrarenal abdominal aortic aneurysm (AAA) surgery and to determine whether thoracic or thoracoabdominal aortic aneurysm repair after prior infrarenal AAA surgery is associated with higher mortality and morbidity rates. ⋯ A considerable group of patients with thoracic or thoracoabdominal aortic aneurysms have had prior AAA repair. The risk of postoperative morbidity is increased in these patients. Mortality appears to be similar for patients with thoracoabdominal aortic aneurysms. Patients with prior AAA repair undergoing thoracic or thoracoabdominal aortic aneurysm repair should be provided maximum care to protect their spinal cord and renal function.
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Review Meta Analysis Comparative Study
Endarterectomy vs stenting for carotid artery stenosis: a systematic review and meta-analysis.
The relative efficacy and safety of endarterectomy and stenting in patients with carotid stenosis remain unclear. In this review we synthesize the available evidence derived from randomized controlled trials (RCTs) that compared the two procedures in terms of the risks of death, stroke (disabling and nondisabling), and nonfatal myocardial infarction. ⋯ In RCTs, carotid stenting and carotid endarterectomy seem equivalent in terms of death and nonfatal myocardial infarction. Although the impact on stroke remains unestablished, results are consistent with a clinically important increase in stroke risk with stenting, an intervention that aims at reducing the risk of stroke.
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Review Meta Analysis Comparative Study
Endovascular vs open repair of acute abdominal aortic aneurysms--a systematic review and meta-analysis.
To compare the results of emergency open repair of acute (ruptured or symptomatic intact) abdominal aortic aneurysms with that of endovascular repair. ⋯ This meta-analysis suggests benefits to the selected group of patients undergoing this minimally invasive procedure. There is a reduction in the high mortality, prolonged intensive care requirement and total hospital stay, which are historically associated with open repair. It also indicates that most patients are fit enough to undergo computerized tomography (CT) scanning in acute settings. However, because of heterogeneity and bias in the outcomes these results should be interpreted with caution.