000			05338nam a22005417a 4500
008			241030s20242024 xxu||||| |||| 00| 0 eng d
022			_a1526-6028
040			_aOvid MEDLINE(R)
099			_a39148208
245			_aA Scoping Review of Definitions of Success in Endovascular Aortic Arch Repair. [Review]
251			_aJournal of Endovascular Therapy. :15266028241271679, 2024 Aug 15
252			_aJ Endovasc Ther. :15266028241271679, 2024 Aug 15
253			_aJournal of endovascular therapy : an official journal of the International Society of Endovascular Specialists
260			_c2024
260			_fFY2025
260			_p2024 Aug 15
265			_saheadofprint
265			_tPublisher
266			_d2024-10-30
266			_z2024/08/16 00:23
501			_aAvailable online from MWHC library: 1994 - 1999, Available in print through MWHC library: 1999 - present
520			_aCLINICAL IMPACT: Total endovascular and extra-anatomic cervical debranching hybrid operations are being increasingly utilized for complex aortic arch repair. These techniques, however, can be associated with serious complications. Currently, there is no accepted metric to define technical or report clinical outcomes. Due to the paucity of high-quality data, use of these approaches may be limited in clinical practice. This study emphasizes the need for the development of standards for reporting outcomes in endovascular aortic arch repair. Future studies can then utilize these benchmarks, whcih will allow for improved efficacy and safety in these techniques.
520			_aCONCLUSION: The definitions of technical success that were provided fell short of analogous defined reporting standards in nearly all studies, inflating technical success rates. Definitions of cerebrovascular events and technical success require stringent criteria to uniformly compare various methods of endovascular aortic arch repair. A societal consensus document for reporting standards of endovascular aortic arch repair would allow for higher-quality outcomes research.
520			_aINTRODUCTION: The present standard of care to treat aortic arch pathologies is open surgical repair with cardiopulmonary bypass and deep hypothermic arrest. With approaches for total endovascular and extra-anatomic cervical debranching hybrid arch repair becoming more diverse, understanding what is considered a successful operation is prerequisite for a rigorous comparison of techniques. This review describes the specific outcomes reported, the rates of success, and the definitions of technical and clinical success in total endovascular and extra-anatomic cervical debranching hybrid aortic arch repair.
520			_aMETHODS: A comprehensive search of MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials was performed. Studies with patients undergoing total endovascular or hybrid extra-anatomic cervical debranching repair of the aortic arch were included. Any publications including only patients with Ishimaru zone 2 or distal repairs were excluded from this review. Studies with less than 5 patients were excluded. Data extraction was performed by one author. Data items included were study design, procedure type, procedural details, underlying pathology, type of cervical debranching, type of endograft repair, surgical outcomes, definition of cerebrovascular events, technical success, and the definition of technical success.
520			_aRESULTS: Of 1754 studies screened for review, 85 studies with 5521 patients were included. By frequency, the included studies examined the following interventions: fenestrated devices, branched devices, parallel grafting. Most studies were retrospective single-institution studies. There were no randomized controlled trials. Short-term mortality and cerebrovascular events were nearly universally reported, present in 99% and 95% of studies reviewed, respectively. Only 27% of studies provided an explicit definition for cerebrovascular events. While 75% of studies reported a technical success rate, only 45% of those studies provided explicit criteria. Clinical success rates were infrequently reported, present in only 5.9% of studies reviewed.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Heart & Vascular Institute
651			_aMedStar Washington Hospital Center
656			_aEmergency Medicine
656			_aSurgery/Vascular Surgery
656			_aVascular Surgery Integrated Residency
657			_aJournal Article
657			_aReview
700			_aAbramowitz, Steven _bMWHC
700			_aFatima, Javairiah _bMHVI
700			_aHockstein, Maxwell _bMWHC
700			_aIlyas, Sadia _bMHVI
700			_aMaloni, Krystal _bMHVI
700			_aRossi, Matthew _bMWHC _cVascular Surgery Integrated Residency _dMD
700			_aShults, Christian _bMHVI
790			_aRossi MJ, Ilyas S, Abramowitz SD, De Freitas S, Hockstein MA, Maloni KC, Shults C, Fatima J
856			_uhttps://dx.doi.org/10.1177/15266028241271679 _zhttps://dx.doi.org/10.1177/15266028241271679
858			_yHockstein, Maxwell A _uhttps://orcid.org/0000-0003-4314-973X _zhttps://orcid.org/0000-0003-4314-973X
858			_yRossi, Matthew J _uhttps://orcid.org/0000-0003-1969-6784 _zhttps://orcid.org/0000-0003-1969-6784
942			_cART _dArticle
999			_c14691 _d14691