Open Surgical Versus Endovascular Repair for Type B Aortic Dissection: Umbrella Review and Meta-Analysis
<p dir="ltr">This umbrella review (UR) synthesizes the current evidence comparing thoracic endovascular aortic repair (TEVAR) with open surgical repair (OSR) for the management of type B aortic dissection (TBAD), with a focus on both early and long-term outcomes. A systematic literat...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | , , , , , , |
| Published: |
2025
|
| Subjects: | |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1864513523943473152 |
|---|---|
| author | Hassan Al-Thani (440106) |
| author2 | Osamah Alrawi (23124721) Eman Elmenyar (23124724) Mashhood Naduvilekandy (19261455) Shams O. Alkhateeb (23124727) Waqar Mogassabi (23124730) Lama Alkahlout (22392196) Ayman El-Menyar (440103) |
| author2_role | author author author author author author author |
| author_facet | Hassan Al-Thani (440106) Osamah Alrawi (23124721) Eman Elmenyar (23124724) Mashhood Naduvilekandy (19261455) Shams O. Alkhateeb (23124727) Waqar Mogassabi (23124730) Lama Alkahlout (22392196) Ayman El-Menyar (440103) |
| author_role | author |
| dc.creator.none.fl_str_mv | Hassan Al-Thani (440106) Osamah Alrawi (23124721) Eman Elmenyar (23124724) Mashhood Naduvilekandy (19261455) Shams O. Alkhateeb (23124727) Waqar Mogassabi (23124730) Lama Alkahlout (22392196) Ayman El-Menyar (440103) |
| dc.date.none.fl_str_mv | 2025-12-12T09:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1177/00033197251392660 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Open_Surgical_Versus_Endovascular_Repair_for_Type_B_Aortic_Dissection_Umbrella_Review_and_Meta-Analysis/31239988 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Cardiovascular medicine and haematology Health sciences Epidemiology type B aortic dissection endovascular open surgery mortality |
| dc.title.none.fl_str_mv | Open Surgical Versus Endovascular Repair for Type B Aortic Dissection: Umbrella Review and Meta-Analysis |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <p dir="ltr">This umbrella review (UR) synthesizes the current evidence comparing thoracic endovascular aortic repair (TEVAR) with open surgical repair (OSR) for the management of type B aortic dissection (TBAD), with a focus on both early and long-term outcomes. A systematic literature search was performed using PubMed, Embase, Cochrane Library, and Web of Science (2014-2025). Eleven systematic reviews met the inclusion criteria. Short-term mortality was lower with TEVAR, ranging from 2% to13.4%, while it was 4.5% to 19% with OSR. The meta-analysis showed a risk ratio (RR) of 0.51 (95% CI: 0.43-0.59; <i>I</i><sup><em>2</em></sup> = 64.6%) in favor of TEVAR. Long-term survival was comparable. TEVAR was associated with fewer complications, including cardiac events (odds ratio [OR]: 0.42-0.79), pulmonary events (OR: 0.51-0.57), renal failure (OR: 0.53-0.63), and bleeding (OR: 0.24 and RR: 0.44). For stroke, the UR showed mixed results (OR: 0.23-1.11), but the meta-analysis showed a lower risk with TEVAR (RR: 0.67; 95% CI: 0.54-0.82; <i>I</i><sup><em>2</em></sup> = 8.7%). Paraplegia rates were comparable (RR: 0.88; 95% CI: 0.53-1.47; <i>I</i><sup><em>2</em></sup> = 22.7%). Despite the observed moderate to high heterogeneity among most studies ( <i>I</i><sup><em>2</em></sup> = 30%-64.6%), the overall trend favored TEVAR in terms of early outcomes. There was a need for further high-quality, longitudinal studies and randomized controlled trials.</p><h2 dir="ltr">Other Information</h2><p dir="ltr">Published in: Angiology<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1177/00033197251392660" target="_blank">https://dx.doi.org/10.1177/00033197251392660</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_75d2e9b036a430bcebdf798b95e88923 |
| identifier_str_mv | 10.1177/00033197251392660 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/31239988 |
| publishDate | 2025 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Open Surgical Versus Endovascular Repair for Type B Aortic Dissection: Umbrella Review and Meta-AnalysisHassan Al-Thani (440106)Osamah Alrawi (23124721)Eman Elmenyar (23124724)Mashhood Naduvilekandy (19261455)Shams O. Alkhateeb (23124727)Waqar Mogassabi (23124730)Lama Alkahlout (22392196)Ayman El-Menyar (440103)Biomedical and clinical sciencesCardiovascular medicine and haematologyHealth sciencesEpidemiologytype Baortic dissectionendovascularopen surgerymortality<p dir="ltr">This umbrella review (UR) synthesizes the current evidence comparing thoracic endovascular aortic repair (TEVAR) with open surgical repair (OSR) for the management of type B aortic dissection (TBAD), with a focus on both early and long-term outcomes. A systematic literature search was performed using PubMed, Embase, Cochrane Library, and Web of Science (2014-2025). Eleven systematic reviews met the inclusion criteria. Short-term mortality was lower with TEVAR, ranging from 2% to13.4%, while it was 4.5% to 19% with OSR. The meta-analysis showed a risk ratio (RR) of 0.51 (95% CI: 0.43-0.59; <i>I</i><sup><em>2</em></sup> = 64.6%) in favor of TEVAR. Long-term survival was comparable. TEVAR was associated with fewer complications, including cardiac events (odds ratio [OR]: 0.42-0.79), pulmonary events (OR: 0.51-0.57), renal failure (OR: 0.53-0.63), and bleeding (OR: 0.24 and RR: 0.44). For stroke, the UR showed mixed results (OR: 0.23-1.11), but the meta-analysis showed a lower risk with TEVAR (RR: 0.67; 95% CI: 0.54-0.82; <i>I</i><sup><em>2</em></sup> = 8.7%). Paraplegia rates were comparable (RR: 0.88; 95% CI: 0.53-1.47; <i>I</i><sup><em>2</em></sup> = 22.7%). Despite the observed moderate to high heterogeneity among most studies ( <i>I</i><sup><em>2</em></sup> = 30%-64.6%), the overall trend favored TEVAR in terms of early outcomes. There was a need for further high-quality, longitudinal studies and randomized controlled trials.</p><h2 dir="ltr">Other Information</h2><p dir="ltr">Published in: Angiology<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1177/00033197251392660" target="_blank">https://dx.doi.org/10.1177/00033197251392660</a></p>2025-12-12T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1177/00033197251392660https://figshare.com/articles/journal_contribution/Open_Surgical_Versus_Endovascular_Repair_for_Type_B_Aortic_Dissection_Umbrella_Review_and_Meta-Analysis/31239988CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/312399882025-12-12T09:00:00Z |
| spellingShingle | Open Surgical Versus Endovascular Repair for Type B Aortic Dissection: Umbrella Review and Meta-Analysis Hassan Al-Thani (440106) Biomedical and clinical sciences Cardiovascular medicine and haematology Health sciences Epidemiology type B aortic dissection endovascular open surgery mortality |
| status_str | publishedVersion |
| title | Open Surgical Versus Endovascular Repair for Type B Aortic Dissection: Umbrella Review and Meta-Analysis |
| title_full | Open Surgical Versus Endovascular Repair for Type B Aortic Dissection: Umbrella Review and Meta-Analysis |
| title_fullStr | Open Surgical Versus Endovascular Repair for Type B Aortic Dissection: Umbrella Review and Meta-Analysis |
| title_full_unstemmed | Open Surgical Versus Endovascular Repair for Type B Aortic Dissection: Umbrella Review and Meta-Analysis |
| title_short | Open Surgical Versus Endovascular Repair for Type B Aortic Dissection: Umbrella Review and Meta-Analysis |
| title_sort | Open Surgical Versus Endovascular Repair for Type B Aortic Dissection: Umbrella Review and Meta-Analysis |
| topic | Biomedical and clinical sciences Cardiovascular medicine and haematology Health sciences Epidemiology type B aortic dissection endovascular open surgery mortality |