TY  - BOOK
AU  - Abramowitz, Steven D
AU  - De Freitas, Simon Peter
AU  - Fatima, Javairiah
AU  - Kiguchi, Misaki M
AU  - Rossi, Matthew John
AU  - Vallabhaneni, Raghuveer
AU  - Woo, Edward Y
TI  - Systematic review and meta-analysis of endovascular interventions for Stanford type A aortic dissection. [Review]
SN  - 0741-5214
PY  - 2021///
KW  - *Aneurysm, Dissecting/su [Surgery]
KW  - *Aortic Aneurysm/su [Surgery]
KW  - *Blood Vessel Prosthesis Implantation
KW  - *Endovascular Procedures
KW  - Adult
KW  - Aged
KW  - Aged, 80 and over
KW  - Aneurysm, Dissecting/dg [Diagnostic Imaging]
KW  - Aneurysm, Dissecting/mo [Mortality]
KW  - Aortic Aneurysm/dg [Diagnostic Imaging]
KW  - Aortic Aneurysm/mo [Mortality]
KW  - Blood Vessel Prosthesis Implantation/ae [Adverse Effects]
KW  - Blood Vessel Prosthesis Implantation/mo [Mortality]
KW  - Clinical Decision-Making
KW  - Endovascular Procedures/ae [Adverse Effects]
KW  - Endovascular Procedures/mo [Mortality]
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Patient Safety
KW  - Risk Assessment
KW  - Risk Factors
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Surgery/Vascular Surgery
KW  - Journal Article
KW  - Review
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - CONCLUSION: The technique for endovascular repair of type A aortic dissection is feasible and reproducible. Meta-analysis of short-term outcomes demonstrate an acceptable safety profile in inoperable patients who otherwise would have an extremely poor prognosis. Data from clinical trials are required before the technique can be introduced into routine clinical practice. Copyright (c) 2021. Published by Elsevier Inc; METHODS: The systematic review and meta-analysis was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Online literature databases searches were current through April 2020. Demographic and procedural characteristics of individual studies were tabulated. Data on technical success, short-term mortality, stroke and reintervention were extracted and underwent meta-analysis using a random-effects model; OBJECTIVE: The standard surgical approach to Stanford type A aortic dissection is open repair. Up to one-in-four patients are declined surgery due to prohibitive risk. Patients that are managed nonoperatively have an unacceptably high mortality. Endovascular repair of the ascending aorta is emerging as an alternative for a select group of patients. The reported rates of technical success, mortality, stroke and reintervention are variable. The objective of this study is to systematically report on outcomes for acute type A dissections repaired with an endovascular approach; RESULTS: Fourteen studies with 80 aortic dissections (55 acute, 25 subacute) were included in the final analysis. There was wide variation in technique and device design across studies. Outcomes rates were estimated at 17% (95% CI: 10-26%) for mortality, 15% (95% CI: 8-23%) for technical failure, 11% (95% CI: 6-19%) for stroke and 18% (95% CI: 9-31%) for reinterventions. The mean Downs and Black quality assessment score was 13.9 (SD +/-3.2)
UR  - https://dx.doi.org/10.1016/j.jvs.2021.01.054
ER  -