{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:51:50Z","timestamp":1791366710392,"version":"4.3.1"},"reference-count":75,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The frozen elephant trunk (FET) and Ascyrus Medical Dissection Stent (AMDS) are hybrid techniques used in managing acute type A aortic dissection (ATAAD). This systematic review and meta-analysis compared their perioperative outcomes, aortic remodeling, and incidence of distal anastomotic new entry (DANE).<\/jats:p>\n                  <jats:p>A comprehensive search yielded 611 studies; after screening, 68 were included\u201459 on FET and 9 on AMDS\u2014covering 7,420 patients (7,070 FET; 350 AMDS). The primary outcome was DANE incidence. Secondary outcomes included operative time, false lumen thrombosis, ICU\/hospital stay, and 30-day\/in-hospital mortality.<\/jats:p>\n                  <jats:p>DANE incidence was 7% in both groups. FET was associated with shorter operative times (353\u2013369 vs. 422\u2009minutes), higher false lumen thrombosis rates (88\u201389% vs. 84%), and longer hospital stays (17\u201319 vs. 9\u201311 days). AMDS had longer ICU stays (7.7\u20138.5 vs. 5.3\u20137.5 days). Mortality rates were similar (FET: 8\u20139%; AMDS: 7\u201310%). Critically, neurological complication rates were substantially higher with AMDS (33% [15\u201353%]) compared with FET (13% [10\u201316%]). However, the evidence base for AMDS remains limited (9 studies) compared with FET (59 studies). Egger's test showed publication bias in FET studies for DANE and length of stay outcomes; bias assessment for AMDS was limited by study number.<\/jats:p>\n                  <jats:p>Limited available evidence suggests that FET and AMDS show similar DANE and mortality outcomes. FET may favor better remodeling and a safer neurological profile, but longer hospitalization, though high heterogeneity and limited AMDS data underscore the need for robust comparative trials.<\/jats:p>","DOI":"10.1055\/a-2737-6653","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T23:41:28Z","timestamp":1762386088000},"page":"519-528","source":"Crossref","is-referenced-by-count":1,"title":["Stent versus Trunk: Who Wins the Aortic Tug-of-War in Type A Dissection? A Systematic Review and Single-Arm Meta-Analysis"],"prefix":"10.1055","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8213-772X","authenticated-orcid":false,"given":"Noor","family":"Abu Hantash","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Jordan, Amman, Jordan"},{"name":"Cardiothoracic Surgery Interest Group, University of Jordan, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Alzubaidi","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Jordan, Amman, Jordan"},{"name":"Cardiothoracic Surgery Interest Group, University of Jordan, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousef","family":"Alghzawi","sequence":"additional","affiliation":[{"name":"School of Medicine, Jordan University of Science and Technology, Irbid, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Yaish","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Jordan, Amman, Jordan"},{"name":"Cardiothoracic Surgery Interest Group, University of Jordan, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayat","family":"Hussain","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Jordan, Amman, Jordan"},{"name":"Cardiothoracic Surgery Interest Group, University of Jordan, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leen","family":"Aburumman","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Jordan, Amman, Jordan"},{"name":"Cardiothoracic Surgery Interest Group, University of Jordan, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Alkurdi","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Jordan, Amman, Jordan"},{"name":"Cardiothoracic Surgery Interest Group, University of Jordan, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Halloum","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, University Medical Center Mainz (Johannes Gutenberg University Mainz), Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6070-9490","authenticated-orcid":false,"given":"Hazem","family":"El-Beyrouti","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, University Medical Center Mainz (Johannes Gutenberg University Mainz), Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"issue":"04","key":"ref1","first-page":"350","article-title":"Presentation, diagnosis, and outcomes of acute 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