A population-based analysis of endovascular aortic stent graft therapy in patients with liver cirrhosis

Chou, An‐Hsun; Chen, Ching-Chang; Lin, Yu‐Sheng; Lin, Ming‐Shyan; Wu, Victor Chien‐Chia; Ting, Pei‐Chi; Chen, Shaowei

doi:10.1016/j.jvs.2018.06.225

Cited by 11 publications

(9 citation statements)

References 41 publications

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“…Consistent with previous studies ( 4 ), patients with decreased liver function experienced significantly higher follow-up mortality than those without. The result remained the same in all subgroups considered and after careful statistical adjustments.…”

Section: Discussionsupporting

confidence: 91%

“…Few studies have addressed the effect of poor liver function on outcomes in TBAD patients undergoing endovascular treatment. Some researchers supported endovascular treatment for patients with poor liver function ( 4 , 6 ), whereas others argued against this approach due to the risk of fatal coagulation disorder ( 5 , 15 ). Temporary coagulopathy could develop after TEVAR ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

“…In a study enrolling 66,943 patients who underwent endovascular aneurysm repair, chronic liver disease was demonstrated to be a significant risk factor for 30-day mortality (OR, 2.52; P < 0.001) ( 19 ). Nevertheless, Chou et al found that short-term results after endovascular therapy were promising in patients with liver cirrhosis ( 4 ). In their view, it was acceptable to perform endovascular procedures in patients with cirrhosis after careful preoperative preparation and high-quality management.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of Liver Function for Evaluation of Short- and Long-Term Outcomes in Type B Aortic Dissection Patients Undergoing Thoracic Endovascular Aortic Repair

Liu

Xie

et al. 2021

Front. Cardiovasc. Med.

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Background and Aims: Patients with decreased liver function suffer from poor outcomes when undergoing procedures. We aimed to explore the impact of liver fibrosis identified by aspartate transaminase-to-platelet ratio index (APRI) and poor liver functional reserve assessed by a model of end-stage liver disease (MELD) and albumin–bilirubin(ALBI) score on the prognosis of patients with type B aortic dissection (TBAD) undergoing thoracic endovascular aortic repair (TEVAR).Methods: A retrospective analysis of a prospectively maintained database from 2010 to 2017 was performed. APRI > 0.5 was used to identify those with significant liver fibrosis. Logistic and Cox regression analyses were performed to investigate the association between liver fibrosis, MELD, and ALBI with adverse events.Results: TEVAR was performed on 812 TBAD patients including 35 with liver fibrosis and 777 without. Twenty-four (3.0%) patients deceased during hospitalization and 69 (8.8%) patients died after a median 48.2 months follow-up. Multivariable analysis revealed that liver fibrosis, MELD, and ALBI were independently associated with in-hospital [fibrosis: odds ratio (OR) 23.73, 95% confidence interval (CI) 8.89–63.33, P < 0.001; MELD: OR 1.08, 95% CI 1.03–1.14, P = 0.003; ALBI: OR 4.45; 95% CI 1.56–12.67, P = 0.005] and follow-up mortality [fibrosis: hazard ratio (HR) 4.69, 95% CI 1.93–11.42, P = 0.001; MELD: HR 1.07, 95% CI 1.04–1.10, P < 0.001; ALBI: HR 2.88, 95% CI 1.53–5.43, P = 0.001]. The association was further corroborated by a subgroup analysis.Conclusion: Liver fibrosis and poor liver functional reserve could significantly increase the morbidity and mortality after TEVAR. APRI, MELD, and ALBI should be calculated and routinely used for preoperative risk stratification. Strict preoperative preparation and elaborate postoperative care are necessary to improve these patients' prognosis.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Assessment of Liver Function for Evaluation of Short- and Long-Term Outcomes in Type B Aortic Dissection Patients Undergoing Thoracic Endovascular Aortic Repair

Liu

Xie

et al. 2021

Front. Cardiovasc. Med.

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“…[ 17 ] A considerable number of published articles have used NHIRD data. [ 11 , 18 , 19 ] Disease diagnoses are based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The Chang Gung Memorial Hospital Ethics Review Committee evaluated and approved this study.…”

Section: Methodsmentioning

confidence: 99%

“…[ 1 – 5 ] Although long-term outcomes remain unclear compared with open repair in the general population, multiple randomized controlled trials have reported that EVAR and TEVAR were associated with lower perioperative morbidity and mortality rates [ 6 – 8 ] ; accordingly, patients with complex comorbidities who are considered to be at “high risk” for open surgery could benefit from EVAR and TEVAR. [ 9 – 11 ]…”

Section: Introductionmentioning

confidence: 99%

Late outcomes of endovascular aortic stent graft therapy in patients with chronic kidney disease

Wu¹,

Chou

Lin

et al. 2020

Medicine

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Open Abdominal Aortic and Iliac Aneurysm Repair in a Patient with Cirrhosis of the Liver

Hans

2020

Challenging Arterial Reconstructions

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A population-based analysis of endovascular aortic stent graft therapy in patients with liver cirrhosis

Cited by 11 publications

References 41 publications

Assessment of Liver Function for Evaluation of Short- and Long-Term Outcomes in Type B Aortic Dissection Patients Undergoing Thoracic Endovascular Aortic Repair

Assessment of Liver Function for Evaluation of Short- and Long-Term Outcomes in Type B Aortic Dissection Patients Undergoing Thoracic Endovascular Aortic Repair

Late outcomes of endovascular aortic stent graft therapy in patients with chronic kidney disease

Open Abdominal Aortic and Iliac Aneurysm Repair in a Patient with Cirrhosis of the Liver

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