BACKGROUND: Acute type B aortic dissection (ATBAD) is a life-threatening condition. Open chest surgical repair using a prosthetic graft has been a conventional treatment for ATBAD. During the past decade, thoracic endovascular aortic repair (TEVAR), which is considered as a less invasive and potentially safer technique, has been increasingly used to treat this condition. Evidence is needed to support the use of TEVAR for these patients. The aim of this review was to assess the efficacy of TEVAR versus conventional open surgery in patients with ATBAD. METHODS: For this review, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (last searched: 2010, issue 4), MEDLINE, EMBASE, CINAHL, Web of Science, and the Chinese Biomedicine Database for clinical trials until January 18, 2011. Controlled trials in which patients with ATBAD were assigned to TEVAR or open surgical repair were included. For each outcome, we evaluated the quality of the evidence with reference to the Grading of Recommendations Assessments, Development, and Evaluation criteria. At the end, we used RevMan 5.0 software to analyze the datum. RESULTS: Five trials (318 participants) are included in this review. As determined by the Grading of Recommendations Assessments, Development, and Evaluation approach, the result quality was low for 30-day mortality and very low for other variables. TEVAR can significantly reduce the short-term mortality for ATBAD (Mantel-Haenszel fixed odds ratio [95% confidence interval]: 0.19 [0.09-0.39], P < 0.001). TEVAR cannot significantly improve postoperative complications or long-term mortality. CONCLUSIONS: TEVAR can be weakly recommended as an alternative for the selective treatment of ATBAD but cannot always be used in case of surgery.
BACKGROUND: Acute type B aortic dissection (ATBAD) is a life-threatening condition. Open chest surgical repair using a prosthetic graft has been a conventional treatment for ATBAD. During the past decade, thoracic endovascular aortic repair (TEVAR), which is considered as a less invasive and potentially safer technique, has been increasingly used to treat this condition. Evidence is needed to support the use of TEVAR for these patients. The aim of this review was to assess the efficacy of TEVAR versus conventional open surgery in patients with ATBAD. METHODS: For this review, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (last searched: 2010, issue 4), MEDLINE, EMBASE, CINAHL, Web of Science, and the Chinese Biomedicine Database for clinical trials until January 18, 2011. Controlled trials in which patients with ATBAD were assigned to TEVAR or open surgical repair were included. For each outcome, we evaluated the quality of the evidence with reference to the Grading of Recommendations Assessments, Development, and Evaluation criteria. At the end, we used RevMan 5.0 software to analyze the datum. RESULTS: Five trials (318 participants) are included in this review. As determined by the Grading of Recommendations Assessments, Development, and Evaluation approach, the result quality was low for 30-day mortality and very low for other variables. TEVAR can significantly reduce the short-term mortality for ATBAD (Mantel-Haenszel fixed odds ratio [95% confidence interval]: 0.19 [0.09-0.39], P < 0.001). TEVAR cannot significantly improve postoperative complications or long-term mortality. CONCLUSIONS:TEVAR can be weakly recommended as an alternative for the selective treatment of ATBAD but cannot always be used in case of surgery.
Authors: Sang-Pil Kim; Han Cheol Lee; Tae Sik Park; Jin Hee Ahn; Hye-Won Lee; Jong-Ha Park; Junhyok Oh; Jung Hyun Choi; Kwang Soo Cha Journal: J Korean Med Sci Date: 2015-03-19 Impact factor: 2.153
Authors: Jong Ha Park; Han Cheol Lee; Jeong Cheon Choe; Sang-Pil Kim; Tae Sik Park; Jinhee Ahn; Jin Sup Park; Hye Won Lee; Jun-Hyok Oh; Jung Hyun Choi; Kwang Soo Cha Journal: Korean Circ J Date: 2017-03-13 Impact factor: 3.243
Authors: Ricardo de Alvarenga Yoshida; Renato Fanchiotti Costa; Débora Ortigosa Cunha; Rafael Mendes Palhares; Rodrigo Gibin Jaldin; Marcone Lima Sobreira; Rafael Elias Farres Pimenta; Winston Bonetti Yoshida Journal: J Vasc Bras Date: 2021-09-06
Authors: John A Treffalls; Christopher B Sylvester; Umang Parikh; Rodrigo Zea-Vera; Christopher T Ryan; Qianzi Zhang; Todd K Rosengart; Matthew J Wall; Joseph S Coselli; Subhasis Chatterjee; Ravi K Ghanta Journal: JTCVS Open Date: 2022-07-11