Are systemic diseases a risk factor for post-implantation syndrome? A systematic review and meta-analysis

Abstract

Objectives: Endovascular aneurysm repair (EVAR) causes less perioperative morbidity versus the open surgical technique. In this review, we discuss whether systemic diseases have a role in the development of post-implantation syndrome (PIS). Patients and methods: Literature search was performed using the PubMed, Scopus, and Web of Science electronic databases without date limitation and manually from the references of the related articles. Only English-language studies were included in which PIS developed after EVAR and systemic diseases were preoperatively recorded. The results of analysis were evaluated with random or fixed effect models according to the presence of heterogeneity (I2>25%). Results: A total of 1,894 articles were reached. After reviewing the titles and abstracts, six articles including 947 patients which met the inclusion criteria were included in the meta-analysis. Coronary artery disease (odds ratio [OR]: 0.6, 95% confidence interval [CI]: 0.42-0.86; p=0.006), chronic obstructive pulmonary disease (OR: 0.67, 95% CI: 0.46-0.98; p=0.041), and heart failure (OR: 0.53, 95% CI: 0.31-0.92; p=0.02) increased the possibility of PIS development. The studies were heterogeneous for chronic obstructive lung disease and renal failure (I2>25%). Publication bias according to the Begg’s test was significant, except for the studies including renal failure (tau2