METHODS: A systematic search on PubMed, Scopus, and Web of Science for articles published by August 2023 was performed. The primary end points were primary patency and secondary patency.
RESULTS: Eleven retrospective case series, involving 579 patients, were incorporated in the review with 88.9% of the included lesions being categorized as Trans-Atlantic Inter-Society Consensus (TASC) C or D. The pooled primary patency estimates at 12, 24 and 36 months were 94.4% (95% confidence interval [CI], 89.4-99.7), 84.4% (95% CI, 72.3-98.5) and 83.8% (95% CI, 71.4-98.3) respectively. The mean primary patency time, representing the period during which individuals remained event-free, was 51.9 months (95% CI, 43.6-55.4). The pooled 36 months primary patency for studies with a predominantly claudicant patient population (>75% of patients) was 89.4% (95% CI, 78.5-100.0), compared with 71.5% (95% CI, 45.6-100.0) for studies with a mixed population (50% of patients). The pooled 36 months primary patency for studies with a predominantly TASC D patient population (>82% of patients) was 70.4% (95% CI, 46.4-100.0) compared with 91.0% (95% CI, 79.1-100.0) for studies with a more homogenous cohort. The pooled secondary patency estimates at 12, 24, and 36 months were 98.6% (95% CI, 96.2-100.0), 97% (95% CI, 93.1-100.0), and 97% (95% CI, 93.1-100.0), respectively. The pooled technical success, 30-day mortality and 30-day systemic complications estimates were 95.9% (95% CI, 93.7- 97.4), 1.9% (95% CI, 1.0-3.5), and 6.4% (95% CI, 4.4-9.1), respectively. The pooled intraoperative and postoperative 30-day CERAB-related complications estimates were 7.3% (95% CI, 2.0-23.0) and 4.2% (95% CI, 0.7-21.0), respectively. The pooled major amputation and target lesion reinterventions by the end of follow-up were 1.9% (95% CI, 1.0-3.4) and 13.9% (95% CI, 9.9-19.2), respectively. The pooled access site complication estimate was 11.7% (95% CI, 5.9-21.7).
CONCLUSIONS: Although this review has showcased the safety and feasibility of the CERAB technique in treating AID, it has also highlighted the necessity for a close and prolonged follow-up period extending beyond 1 year. Moreover, the favorable secondary patency estimates predominantly attained via endovascular reinterventions emphasize a potentially advantageous characteristic of the CERAB technique, particularly valuable when addressing late-stage AID disease or anatomically complex lesions.
方法:在PubMed上进行系统搜索,Scopus和Webofscience为2023年8月发表的文章进行了表演。主要终点是原发性通畅和继发性通畅。
结果:11个回顾性病例系列,涉及579名患者,纳入审查,其中88.9%的病变被归类为跨大西洋社会共识文件(TASC)C或D。24个月和36个月为94.4%(95%CI:89.4-99.7),84.4%(95%CI:72.3-98.5)和83.8%(95%CI:71.4-98.3)。平均初级通畅时间,代表个人保持无事件状态的时期,为51.9个月(95%CI:43.6-55.4)。合并36个月的主要通畅性患者(>75%的患者)为89.4%(95%CI:78.5-100),与混合人群(50%的患者)的研究相比,71.5%(95%CI:45.6-100.0)。对于主要为TASCD患者人群(>82%的患者)的研究,合并的36个月主要通畅率为70.4%(95%CI:46.4-100.0),而对于具有更同质队列的研究为91.0%(95%CI:79.1-100)。汇总的二级通畅度估计为12点,24个月和36个月为98.6%(95%CI:96.2-100),97%(95%CI:93.1-100)和97%(95%CI:93.1-100)。汇集的技术成功,30天死亡率和30天全身并发症估计值为95.9%(95%CI:93.7-97.4),1.9%(95%CI:1.0-3.5)和6.4%(95%CI:4.4-9.1)。合并的术中和术后30天CERAB相关并发症估计值分别为7.3%(95%CI:2.0-23.0)和4.2%(95%CI:0.7-21.0)。随访结束时合并的主要截肢和目标病变再干预分别为1.9%(95%CI:1.0-3.4)和13.9%(95%CI:9.9-19.2)。合并的进入部位并发症估计值为11.7%(95%CI:5.9-21.7)。
结论:虽然本综述显示了CERAB技术治疗AID的安全性和可行性,它还强调了持续一年以上的密切和长期随访的必要性。此外,主要通过血管内再介入术获得的有利次要通畅度评估强调了CERAB技术的潜在有利特征,在解决晚期AID疾病或解剖学上复杂的病变时特别有价值。