Evidence map›Paper›PMID 39949432›Full record

ReviewCureus2025

Distal Landing Zone-Related Complications of Conventional Endovascular Aneurysm Repair (EVAR) in the Long Term: A Comprehensive Systematic Review.

Apostolos G Pitoulias, Charalampos N Loutradis, Dimitrios A Chatzelas, Matthaios G Pitoulias, Loukia A Politi, Vangelis Bontinis, Georgios Pitoulias

Abstract readReview
In one paragraph

Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Apostolos G PitouliasDivision of Vascular Surgery, Second Department of Surgery, "G. Gennimatas" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC.
Charalampos N LoutradisDivision of Vascular Surgery, Second Department of Surgery, "G. Gennimatas" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC.
Dimitrios A ChatzelasDivision of Vascular Surgery, Second Department of Surgery, "G. Gennimatas" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC.
Matthaios G PitouliasDivision of Vascular Surgery, Second Department of Surgery, "G. Gennimatas" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC.
Loukia A PolitiDivision of Vascular Surgery, Second Department of Surgery, "G. Gennimatas" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC.
Vangelis BontinisDepartment of Vascular Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC.
Georgios PitouliasDivision of Vascular Surgery, Second Department of Surgery, "G. Gennimatas" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The aim of this systematic review is to evaluate the late-onset complications considering the distal landing zones (DLZ) in patients with abdominal aortic aneurysm (AAA) treated by conventional endovascular aneurysm repair (EVAR). We conducted a systematic review of electronic databases, clinical trial registries, and grey literature to retrieve studies on this issue. The inclusion criteria could be summarized as follows: (1) observational studies or case series with more than 30 patients included, (2) at least three-year follow-up, and (3) endpoints including endoleak type Ib (ELIB) or cranial iliac limb migration/retraction (CLR) or DLZ failure-related reinterventions or other complications. Of the 517 potentially eligible studies, the detailed search revealed eight articles with a total of 2569 patients for further investigation. Due to the extreme heterogeneity in definitions and reporting outcomes among the included studies, the synthesis and meta-analysis of data were not plausible. A quantitative assessment of reported outcomes revealed a pooled incidence of 2.1% for ELIB, 1.7% for CLR, and 5.7% for DLZ failure-related reinterventions. Data were considered controversial to extract a consensus for the dilatation of the DLZ. This systematic review delineates the importance of late-onset complications originating from DLZ failures for the longevity of an EVAR procedure and gathers the current knowledge regarding the magnitude and clinical implications of DLZ failure from the existing literature and in the best available quality. Current literature data show a blurred image regarding the long-term morphological alterations of iliac arteries and especially in the impact of DLZ dilatation and emphasize the necessity of prolonged follow-up for at least five years.

Indexed as

cranial limb migrationdistal landing zoneendoleak type ibendovascular aneurysm repairevarfollow-up

Identifiers

PMID39949432
PMCPMC11821369

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.