ArticleJournal of clinical medicine2023
Endovascular Treatment of Type A Aortic Dissection: A Systematic Review and Meta-Analysis Using Reconstructed Time-to-Event Data.
Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Percutaneous Treatment of Type A Aortic Dissection Using Atrial Septal Defect Occlusion Device.Journal of cardiovascular development and disease · 2026Article
- Beyond Uncertainty: Establishing the Oda Strategy for the Treatment of Acute Aortic Dissection.Journal of clinical medicine · 2025Review
- Surgical management of chronic type A aortic dissection in sub-Saharan Africa: a five-case series from a Beninese center.Journal of surgical case reports · 2025Article
- Pregnancy-Related Aortic Dissection-A Rare Complication of Pregnancy.Clinical case reports · 2025Article
- Research progress on endovascular treatment of Stanford Type A aortic dissection.Frontiers in cardiovascular medicine · 2025Review
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Authors and funding
6 authors.
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Abstract
objectiveThe undisputed gold standard of treatment for type A aortic dissections (TAAD) is open surgery. Anecdotal reports have assessed thoracic endovascular aortic repair (TEVAR) as a last resort for highly selected candidates. The present study aims to evaluate endovascular outcomes in TAAD patients who are unsuitable for open surgery whilst having TEVAR-compatible aortic anatomy.
methodsA PRISMA-compliant systematic search of the PubMed, Scopus, and Cochrane databases was performed up to 19 May 2022. Time-to-event data were reconstructed using Kaplan-Meier curves from the source literature.
resultsIn 20 eligible studies, 311 patients underwent TEVAR for acute, subacute, or chronic TAAD. Mean age at the time of the operation was 60.70 ± 8.00 years and 75.48% (95% Confidence Interval [CI], 60.33-88.46%) of the included patients were males. Mean operative time was 169.40 ± 30.70 min. Overall, 0.44% (95% CI, 0.00-4.83%) of the cases were converted to salvage open surgery. Technical failure, stroke, and endoleaks occurred in 0.22%, 0.1%, and 8.52% of the cohort, respectively. Thirty-day postoperative complication rate was 7.08% (95% CI, 1.52-14.97%), whereas late complications developed in 16.89% (95% CI, 7.75-27.88%) of the patients. One-, three-, and five-year survival rates were estimated at 87.15%, 82.52% and 82.31%, respectively. Reintervention was required in 8.38% of the cohort over a mean follow-up of 32.40 ± 24.40 months.
conclusionsTEVAR seems to be feasible in highly selected patients with TAAD who cannot tolerate open surgery. Overcoming technical limitations and acquiring long-term data are warranted to safely define the place of endovascular treatment in the armamentarium of TAAD repair.
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