PURPOSE To evaluate the comparative outcome and cost of vascular plugs versus coils for internal iliac artery embolization prior to endovascular aortic aneurysm repair. METHOD A search was performed for internal iliac artery embolization studies in adult patients from January 2005 to July 2018. Inclusion criteria included embolization of unilateral or bilateral IIAs with either coils or plug(s) prior to endovascular aortic repair. Meta-analysis was performed using a fixed effects model with the inverse variance-weighted average method to determine pooled differences in surgical time, fluoroscopy time, radiation exposure, number of devices used, cost of devices, and post-embolization buttock claudication. Heterogeneity was assessed using the Chi-square statistic. Pooled outcomes were compared, and quality assessments were evaluated using the Newcastle-Ottawa scale. RESULT Six studies met inclusion criteria. One hundred and eighty-one patients were included in the study, of which 87 were in the plug group and 94 in the coil group. Vascular plug use led to 35.32 min shorter surgery time (p < 0.001), 15.64 min less fluoroscopy time (p < 0.001), 157,599 mGy/cm2 less radiation (p < 0.001), and 5.88 fewer occlusive devices (p < 0.001) than the use of coils alone. The estimated total cost of occlusion devices was $575.45 USD lower in the plug cohort (p < 0.001). The development of buttock claudication 12 months after EVAR was 11% less likely in the plug cohort but was not statistically significant (p = 0.71). CONCLUSION The vascular plug appears to be superior to coils in embolization of the internal iliac artery due to shorter surgical time, fluoroscopy time, radiation exposure, and total cost of occlusive devices.

中文翻译：

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血管栓塞与线圈对I内动脉栓塞的比较结果和成本-效果的Meta分析。

目的评估在血管内主动脉瘤修复之​​前塞与versus塞对for内动脉栓塞的比较结果和成本。方法对2005年1月至2018年7月在成年患者中进行的internal内动脉栓塞研究进行了研究。纳入标准包括在血管内主动脉修复前单侧或双侧IIA伴有线圈或栓塞栓塞。使用固定效果模型和逆方差加权平均法进行荟萃分析，以确定手术时间，荧光透视时间，放射线照射，所用器械数量，器械成本以及栓塞后臀部c行的综合差异。使用卡方统计量评估异质性。比较汇总结果，并使用纽卡斯尔-渥太华量表对质量评估进行评估。结果六项研究符合纳入标准。这项研究共纳入181位患者，其中87位在栓塞组，94位在线圈组。相比之下，使用血管塞可缩短手术时间（p <0.001）35.32分钟（x <0.001），减少透视检查时间（p <0.001）15.64 min，减少放射线（p <0.001）157599 mGy / cm2和减少闭塞装置（p <0.001）5.88单独使用线圈。在塞组中，闭塞器械的估计总成本降低了575.45美元（p <0.001）。EVAR治疗12个月后，臀部lau行的发生率较同龄人群降低11％，但无统计学意义（p = 0.71）。