Endovascular Treatment of Type A Aortic Dissection: A Systematic Review and Meta-Analysis Using Reconstructed Time-to-Event Data

Mylonas, Konstantinos S.; Zoupas, Ioannis; Tasoudis, Panagiotis T.; Vitkos, Evangelos; Stavridis, George T.; Avgerinos, Dimitrios V.

doi:10.3390/jcm12227051

Cited by 2 publications

(1 citation statement)

References 49 publications

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“…For patients to be eligible for endovascular treatment, anatomic feasibility is paramount. Factors such as the location of the entry tear, ascending aortic diameter, involvement of critical structures like the aortic root or coronary arteries, and identification of an appropriate landing zone are crucial considerations [64] .…”

Section: Future Prospect: Endovascular Repair Of Ataadmentioning

confidence: 99%

Acute type a aortic dissection: when not to operate, a review

Faggion Vinholo,

Awtry,

Semco

et al. 2024

Vessel Plus

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Acute type A aortic dissection (ATAAD) is a surgical emergency with a nonoperative mortality rate of up to 1% per hour and an operative mortality rate as high as 24%. Therefore, evaluation of comorbidities and patient presentation characteristics prompts a pause for risk stratification before proceeding to the operating room, as emergent surgery may not always be the optimal approach. This comprehensive review explores key considerations in ATAAD management, emphasizing the need for nuanced decision making, by considering medical management and delayed surgery as an alternative management approach for high-risk populations such as the frail or patients who have a history of cardiac surgery. Beyond the immediate threat of aortic rupture, organ malperfusion stands out as the most feared complication of ATAAD, also elevating perioperative risk significantly. In such cases, careful assessment of patient’s hemodynamic status is paramount. For stable patients, a thorough preoperative strategy and multidisciplinary discussions are encouraged. Notably, the advent of endovascular techniques provides viable lower-risk alternatives to the traditional open approach. The consequences of ATAAD surgical intervention extend beyond the immediate procedural concerns, with a substantial impact on the patient’s overall function. Prioritizing patient-centered care becomes imperative in aligning management with individual goals of care. This review seeks to provide insights into these considerations by offering a stepwise approach to patient-centered decision-making in ATAAD management.

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Section: Future Prospect: Endovascular Repair Of Ataadmentioning

confidence: 99%

Acute type a aortic dissection: when not to operate, a review

Faggion Vinholo,

Awtry,

Semco

et al. 2024

Vessel Plus

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Gamma Knife Stereotactic Radiosurgery for Cerebral Cavernous Malformations: Meta-Analysis of Reconstructed Time-to-Event Data

da Fontoura Galvão,

Verly,

Bessa

et al. 2024

Cerebrovasc Dis

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Introduction: Cavernomas are vascular lesions with a genetic heritage that can be spotted on the central nervous system. Whenever these lesions are localized in eloquent regions, surgical resection is not recommended. In this type of situation, Gamma Knife stereotactic radiosurgery (GKRS) could be a feasible option for treating patients. Thus, we aim to explore the outcomes associated with this procedure. Methods: We performed a systematic review and meta-analysis of reconstructed time-to-event data based on Kaplan-Meier curves. A thorough search was conducted on PubMed, Cochrane, Web of Science and Embase databases targeting papers that provided information regarding hemorrhagic outcomes associated with GKRS through Kaplan-Meier curves. Results: After a systematic search in the specific databases, seven studies were included in this review. Notably, a total of 1071 patients had 1104 cavernomas treated by GKRS. Assessment of short-term and long-term post-procedure outcomes was performed, with the estimated overall events-free rate at 2 years being 89.8% (95% CI 87.7 – 91.5), whilst, at ten years, the estimated overall events-free rate was 71.3% (95% CI 67.2 – 75.1). Conclusion: GKRS seems to be a good alternative for control of symptomatic events in early and long-term follow-up, despite the need of further investigation provided by future studies. Keywords: cavernoma, bleeding, radiosurgery, radiotherapy, vascular.

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Endovascular Treatment of Type A Aortic Dissection: A Systematic Review and Meta-Analysis Using Reconstructed Time-to-Event Data

Cited by 2 publications

References 49 publications

Acute type a aortic dissection: when not to operate, a review

Acute type a aortic dissection: when not to operate, a review

Gamma Knife Stereotactic Radiosurgery for Cerebral Cavernous Malformations: Meta-Analysis of Reconstructed Time-to-Event Data

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