Evidence map›Paper›PMID 40586922›Full record

Trial reportEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2025

Cerebral malperfusion resolution after repair of acute DeBakey type I dissection with a novel hybrid prosthesis: early results of the PERSEVERE Study†.

William Brinkman, John J Squiers, Arminder Jassar, Shinichi Fukuhara, Fernando Fleischman, Hiroo Takayama, Ibrahim Sultan, George Arnaoutakis, Michael C Moon, Wilson Y Szeto and 1 more

Registry-linked trialAbstract readClinical TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05174767 (A ProspEctive, Single ARm, Multi-center Clinical InveStigation to EValuatE the Safety and Effectiveness of AMDS in the TREatment of Acute DeBakey Type I Dissection), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05174767 naactive not recruitingnot on this map

A ProspEctive, Single ARm, Multi-center Clinical InveStigation to EValuatE the Safety and Effectiveness of AMDS in the TREatment of Acute DeBakey Type I Dissection: PERSEVERE

TypeinterventionalSponsorArtivion Inc.Ran2022 to 2029Enrolled115ConditionsAcute Aortic DissectionArmsAMDS
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

William BrinkmanDepartment of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital Plano, Plano, TX, USA.ORCID 0000-0002-6376-9285
John J SquiersDepartment of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital Plano, Plano, TX, USA.ORCID 0000-0003-0608-9934
Arminder JassarCardiac Surgery, Massachusetts General Hospital, Boston, MA, USA.ORCID 0000-0001-5412-3506
Shinichi FukuharaDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA.ORCID 0000-0002-7898-5159
Fernando FleischmanUSC Cardiac and Vascular Institute, University of Southern California, Los Angeles, CA, USA.ORCID 0000-0002-8989-3479
Hiroo TakayamaDivision of Cardiac, Thoracic & Vascular Surgery, Columbia University, New York, NY, USA.ORCID 0000-0002-7840-801X
Ibrahim SultanDivision of Cardiac Surgery, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.ORCID 0000-0002-1737-4012
George ArnaoutakisDivision of Cardiovascular and Thoracic Surgery, Dell Medical School, University of Texas at Austin, Austin, TX, USA.ORCID 0000-0002-7648-0747
Michael C MoonDivision of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.ORCID 0000-0001-6617-8336
Wilson Y SzetoDivision of Cardiovascular Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.ORCID 0009-0007-7560-7738
PERSEVERE Investigators

Funding

Artivion, Inc
6 · The paper itself

Abstract

objectivesPatients undergoing hemiarch repair for acute DeBakey type I dissection (ADTI) are high risk for postoperative stroke, especially if cerebral malperfusion is present preoperatively. We sought to evaluate whether the AMDS Hybrid Prosthesis (AMDS), a bare metal stent designed to promote positive aortic remodelling and prevent distal anastomotic new entry tears, may improve neurological outcomes of patients with ADTI presenting with cerebral malperfusion.

methodsPERSEVERE enrolled patients presenting with ADTI and malperfusion at 26 sites in North America. Among 93 enrolled patients, 30 (32.3%) presented with cerebral malperfusion. We evaluated for resolution of clinical and/or radiological cerebral malperfusion after hemiarch repair with AMDS.

resultsCerebral malperfusion was diagnosed clinically in 19 (63.3%) patients and radiographically in 23 (76.7%) patients. Among the patients with clinical cerebral malperfusion, 18 survived the perioperative period; of these, 11 (61%) experienced complete resolution of preoperative symptoms, 5 (28%) had no worsening of preoperative symptoms, and 2 (11%) had a new disabling stroke postoperatively. At follow-up, the mean true lumen to total arterial diameter ratio (measured by computed tomography angiography) improved from 30.9% to 64.4% (P = 0.002) in the innominate artery and 33.8% to 60.6% (P = 0.005) in the left common carotid artery from preoperative baseline in patients with radiographic cerebral malperfusion.

conclusionsAmong patients presenting with ADTI and cerebral malperfusion, the majority had resolution or stability of neurological symptoms after hemiarch repair using the AMDS. Radiographic indicators of malperfusion also improved. CLINICAL

trial registrationhttps://clinicaltrials.gov/study/NCT05174767.

Indexed as

Aortic Aneurysm, ThoracicAortic DissectionBlood Vessel ProsthesisBlood Vessel Prosthesis ImplantationStentsAdultAgedAorta, ThoracicCerebrovascular CirculationFemaleHumansMaleMiddle AgedPostoperative ComplicationsProsthesis DesignTreatment OutcomeAcute DeBakey type I aortic dissectionCerebral malperfusionFalse lumen thrombosisHemiarch repairHybrid aortic prosthesis

Identifiers

PMID40586922
PMCPMC12263108

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.