Is Multilayer Bare Stent Safe or Effective for the Treatment of Aortic Aneurysms? A Meta-analysis with Early and Mid-term Outcomes.

ABSTRACT

BACKGROUND: As a novel endovascular treatment, multilayer bare stent implantation remains controversial. This study evaluated the safety and efficacy of multilayer bare stent-based endovascular treatment applied in aortic aneurysms in the reported literature. METHODS: Articles regarding multilayer bare stent-based endovascular treatment published before and during February 2016 were obtained by searching PubMed, EMBASE, Wiley Online Library, and Web of Science. R software was employed for a meta-analysis. RESULTS: Five studies including 154 patients satisfied the inclusion criteria. The mean follow-up was 12.7 (8-22.1) months. The rate of aneurysm exclusion was 76.1%. The rate of aneurysm shrinkage and enlargement was 14.1% and 12.5%, respectively. The patency rate of branch vessels was 98.4%. The overall rate of aneurysm rupture was almost 0%. The 30-day postoperative and 1-year aneurysm-related mortality were 0% and 1.7%, respectively. Technical success was achieved in all patients. Only 6.7% of the patients needed reintervention. About 1.9% of the patients suffered endoleak. CONCLUSIONS: Our study indicates that treatment of aneurysms with multilayer bare stents is safe with high technical success rates and low incidence of complications. However, the low rates of aneurysm exclusion are not negligible. Due to the limitations of the existing studies, we only suggest its use for aortic aneurysms with branch vessels if the standard techniques are contraindicated.