The aim of this study was to demonstrate clinical outcomes of intentional coverage of celiac artery (CA) during thoracic endovascular aneurysm repair (TEVAR).
MEDLINE, EMBASE, and Cochrane Library were searched for studies reporting coverage of CA during TEVAR. The methodological quality of included studies was assessed by means of the Moga-Score and Newcastle-Ottawa scale. Random-effects model was used to pool estimates. A meta-analysis was performed with investigation of the following outcomes: visceral ischemia, spinal cord ischemia (SCI), stroke, endoleaks, reintervention, 30-day mortality and 1-year mortality.
Ten studies with 171 patients were included. The summary estimate rate of visceral ischemia events was 4.2% (95% CI, 0.9-8.9%; I =4.1%). The incidences of stroke and SCI were 0.2% (95% CI, 0-3.4%; I=0%) and 3% (95% CI, 0.3-7.4%; I =6.1%). The rate of endoleak during the follow-up period was 24.1% (95% CI, 14.3-35.1%; I=20.0%). Furthermore, reintervention rate was 13.6% (95% CI, 4.4-25.7; I=66.0%). The 30-day and 1-year mortality were 2.9% (95% CI, 0.3-7.2%; I=6.2%) and 15.2% (95% CI, 7.8-23.9%; I=0%).
Among the patients with complex thoracic aortic pathologies deemed at high risk for open reconstruction, TEVAR with intentional coverage of CA is a safe and feasible option to extend the distal sealing zone with acceptable rates of visceral ischemia, SCI, type II endoleak from the CA and 30-day mortality.