Annals of vascular surgery
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Review Meta Analysis
Risk-Adjusted Meta-analysis of 30-Day Mortality of Endovascular Versus Open Repair for Ruptured Abdominal Aortic Aneurysms.
In recent years, the relative benefits of endovascular repair (EVAR) in the treatment of ruptured abdominal aortic aneurysms (rAAAs) compared with those of open repair have been postulated. However, sufficient quantification and evidence-based validation of the role of EVAR in the care pathway for these patients is still lacking. The aim of the present meta-analysis was to investigate the impact of hemodynamic instability and other potential risk factors on 30-day mortality of EVAR versus open repair for rAAAs by performing a meta-regression analysis of previously published data. ⋯ Because a hemodynamically unstable condition may result in poorer clinical outcome, we calculated the 30-day mortality OR adjusted for patients' hemodynamic condition. After adjustment, there was no benefit in 30-day mortality for EVAR compared with that in open surgery.
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Bacillus Calmette-Guerin (BCG) is a live, attenuated strain of Mycobacterium bovis commonly used for the treatment of superficial bladder carcinoma. Intravesical BCG is well tolerated despite side effects that range from hematuria to sepsis syndrome. ⋯ These are challenging to diagnose because of their scarcity, nontraditional culture media, slow growth, and are often lethal. We report the first successful repair of a symptomatic, multifocal TAAA secondary to M bovis manifesting 17 months after intravesical BCG therapy and review the literature.