{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:30:59Z","timestamp":1777501859216,"version":"3.51.4"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Artivion, Inc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Patients undergoing hemiarch repair for acute DeBakey type I dissection (ADTI) are high risk for postoperative stroke, especially if cerebral malperfusion is present preoperatively. We sought to evaluate whether the AMDS Hybrid Prosthesis (AMDS), a bare metal stent designed to promote positive aortic remodelling and prevent distal anastomotic new entry tears, may improve neurological outcomes of patients with ADTI presenting with cerebral malperfusion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>PERSEVERE enrolled patients presenting with ADTI and malperfusion at 26 sites in North America. Among 93 enrolled patients, 30 (32.3%) presented with cerebral malperfusion. We evaluated for resolution of clinical and\/or radiological cerebral malperfusion after hemiarch repair with AMDS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Cerebral malperfusion was diagnosed clinically in 19 (63.3%) patients and radiographically in 23 (76.7%) patients. Among the patients with clinical cerebral malperfusion, 18 survived the perioperative period; of these, 11 (61%) experienced complete resolution of preoperative symptoms, 5 (28%) had no worsening of preoperative symptoms, and 2 (11%) had a new disabling stroke postoperatively. At follow-up, the mean true lumen to total arterial diameter ratio (measured by computed tomography angiography) improved from 30.9% to 64.4% (P\u2009=\u20090.002) in the innominate artery and 33.8% to 60.6% (P\u2009=\u20090.005) in the left common carotid artery from preoperative baseline in patients with radiographic cerebral malperfusion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Among patients presenting with ADTI and cerebral malperfusion, the majority had resolution or stability of neurological symptoms after hemiarch repair using the AMDS. Radiographic indicators of malperfusion also improved.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CLINICAL TRIAL REGISTRATION<\/jats:title>\n                  <jats:p>https:\/\/clinicaltrials.gov\/study\/NCT05174767<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaf199","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T11:12:22Z","timestamp":1751281942000},"source":"Crossref","is-referenced-by-count":1,"title":["Cerebral malperfusion resolution after repair of acute DeBakey type I dissection with a novel hybrid prosthesis: early results of the PERSEVERE Study"],"prefix":"10.1093","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6376-9285","authenticated-orcid":false,"given":"William","family":"Brinkman","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital Plano , Plano, 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