Background: There is a known negative association between diabetes (DM) and abdominal aortic aneurysm (AAA). Patients with DM have a higher long-term mortality following AAA repair. However, whether that is related to their AAA is unclear.
Aims: To determine the rates of reinterventions in patients with DM post-AAA repair. Outcomes included; AAA sac enlargement, reinterventions, endoleaks, AAA rupture, and conversion.
Methods: Pubmed, Embase and Cochrane databases were searched for primary research studies between 2005 and 2022 according to PRISMA guidelines. Patients undergoing AAA repair either via endovascular aneurysm repair or open surgical repair were included. Meta-analysis was conducted using Review Manager.
Results: Eight studies were identified totalling 75678 patients in the control group, and 22284 in the DM group. Patients with DM had a lower rate of reintervention compared to the control group, (6.63% v 9.15%; OR 0.80, 95%CI[0.67, 0.94], P=0.007). There was no significant difference in rate of all endoleaks (8.54% v 12.38%; OR 0.91, 95%CI[0.53-1.58], P=0.74), which remained non-significantly in favour of DM when comparing type 1 and 2 separately, with similar results with sac expansion. There was a significant reduction in rates of conversion to open surgery in those with DM (3.07% v 4.21%; OR 0.75, 95%CI[0.55-0.99], P=0.04), and a reduction in post op AAA rupture (3.35% v 5.69%; OR 0.53, 95%CI[0.49-0.58], P<0.001).
Conclusion: Postoperative AAA ruptures, reinterventions, and conversion to open surgery were lower in patients with DM. However, the rates of endoleaks were not significantly different, so the reason for higher complication rates remains unknown.
K.Dhatariya: Other Relationship; Novo Nordisk, AstraZeneca, Boehringer-Ingelheim, Eli Lilly and Company. E.A.A.Otify: None. M.A.E.Mekki: None. P.W.Stather: None.
