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Elective Endovascular versus Open Surgical Repair of Abdominal Aortic Aneurysms: Systematic Review of Short-term Results¹

¹ From the Dept of Radiology, Massachusetts General Hospital, Harvard Medical School, Zero Emerson Pl, Ste 2H, Boston, MA 02114 (M.E.A.P.M.A., J.L.B., E.F.H., G.S.G.); Depts of Radiology (M.E.A.P.M.A., M.G.M.H.) and Epidemiology and Biostatistics (M.E.A.P.M.A., J.L.B., M.G.M.H.), Erasmus Univ Med Ctr, Rotterdam, the Netherlands; and Dept of Health Policy and Management, Harvard School of Public Health, Boston, Mass (M.G.M.H., G.S.G.). From the 2001 RSNA scientific assembly. Received Oct 12, 2001; revision requested Dec 26; revision received Jan 15, 2002; accepted Mar 12. M.E.A.P.M.A. supported by grants from Foundation Fundatie van de Vrijvrouwe van Renswoude, Foundation Gerrit Jan Mulder Stichting, Netherland-America Foundation, Netherlands Heart Foundation, Foundation Stichting Dr Hendrik Muller’s Vaderlandsch Fonds, Foundation Stichting Jo Kolk Studiefonds, Talentenprogramma Award for Talented Students by the Dutch Ministry of Education, Foundation Van Walree Fonds of the Royal Netherlands Academy of Arts and Sciences, Foundation Vereniging Trustfonds Erasmus Univ Rotterdam, and VSB Foundation. J.L.B., E.F.H., G.S.G. supported in part by the U.S. Dept of the Army under DAMD 17-99-2-9001. The information presented does not necessarily represent the position of the government, and no official endorsement should be inferred. Address correspondence to G.S.G.

View larger version (22K): [in a new window]   Funnel plot shows the reciprocal of the standard error of the 30-day mortality odds ratio, endovascular repair versus open surgical repair, as a function of the natural logarithm of the 30-day mortality odds ratio. The natural logarithm of the pooled 30-day mortality odds ratio is indicated by the square. Horizontal error bars represent 95% CIs. The funnel plot does not demonstrate a funnel-shaped distribution (inverted V shape). Studies with a low reciprocal of the standard error and with a low 30-day mortality odds ratio appear to be missing (lower left-hand corner). This implies that studies with a low mortality for endovascular repair compared with that of open surgical repair are underrepresented, suggesting that there may be publication bias. = studies.