{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T01:36:12Z","timestamp":1792719372181,"version":"4.5.0"},"reference-count":61,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,9,22]]},"abstract":"\n Background<\/jats:title>\n \n Retrograde type A aortic dissection (\n RTAD<\/jats:styled-content>\n ) is a potentially lethal complication after thoracic endovascular aortic repair (\n TEVAR<\/jats:styled-content>\n ). However, data are limited regarding the development of\n RTAD<\/jats:styled-content>\n post\u2010\n TEVAR<\/jats:styled-content>\n . This systematic review aims to define the incidence, mortality, and potential risk factors of\n RTAD<\/jats:styled-content>\n post\u2010\n TEVAR<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Multiple electronic searches were performed. Fifty publications with a total of 8969 patients were analyzed. Pooled estimates for incidence and mortality of\n RTAD<\/jats:styled-content>\n were 2.5% (95% confidence interval [\n CI]<\/jats:styled-content>\n , 2.0\u20133.1) and 37.1% (95%\n CI<\/jats:styled-content>\n , 23.7\u201351.6), respectively. Metaregression analysis evidenced that\n RTAD<\/jats:styled-content>\n rate was associated with hypertension (\n P<\/jats:italic>\n =0.043), history of vascular surgery (\n P<\/jats:italic>\n =0.042), and American Surgical Association (\n P<\/jats:italic>\n =0.044). The relative risk of\n RTAD<\/jats:styled-content>\n was 1.81 (95%\n CI,<\/jats:styled-content>\n 1.04\u20133.14) for acute dissection (relative to chronic dissection) and 5.33 (95%\n CI,<\/jats:styled-content>\n 2.70\u201310.51) for aortic dissection (relative to a degenerative aneurysm). Incidence of\n RTAD<\/jats:styled-content>\n was significantly different in patients with proximal bare stent and nonbare stent endografts (relative risk\n [RR]<\/jats:styled-content>\n =2.06; 95%\n CI,<\/jats:styled-content>\n 1.22\u20133.50).\n RTAD<\/jats:styled-content>\n occurrence rate in zone 0 was higher than other landing zones.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The pooled\n RTAD<\/jats:styled-content>\n rate after\n TEVAR<\/jats:styled-content>\n was calculated at 2.5% with a high mortality rate (37.1%). Incidence of\n RTAD<\/jats:styled-content>\n is significantly more frequent in patients treated for dissection than those with an aneurysm (especially for acute dissection), and\u00a0when the proximal bare stent was used. Rate of\n RTAD<\/jats:styled-content>\n after\n TEVAR<\/jats:styled-content>\n varied significantly according to the proximal Ishimaru landing zone. The more\u2010experienced centers tend to have lower\n RTAD<\/jats:styled-content>\n incidences.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.004649","type":"journal-article","created":{"date-parts":[[2017,9,22]],"date-time":"2017-09-22T20:12:00Z","timestamp":1506111120000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":201,"title":["Retrograde Type A Aortic Dissection After Thoracic Endovascular Aortic Repair: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1161","volume":"6","author":[{"given":"Yanqing","family":"Chen","sequence":"first","affiliation":[{"name":"Division of Vascular Surgery, Changhai Hospital, Shanghai, China"},{"name":"Military Institute of Vascular Disease, The First Affiliated Hospital of the Second Military Medical University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Changhai Hospital, Shanghai, China"},{"name":"Military Institute of Vascular Disease, The First Affiliated Hospital of the Second Military Medical University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Changhai Hospital, Shanghai, China"},{"name":"Military Institute of Vascular Disease, The First Affiliated Hospital of the Second Military Medical University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingsheng","family":"Lu","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Changhai Hospital, Shanghai, China"},{"name":"Military Institute of Vascular Disease, The First Affiliated Hospital of the Second Military Medical University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of statistics, The Second Military Medical University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaiping","family":"Jing","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Changhai Hospital, Shanghai, China"},{"name":"Military Institute of Vascular Disease, The First Affiliated Hospital of the Second Military Medical University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2006.03.055"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2007.10.010"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2008.03.024"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)34288-6"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/15266028040110S609"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2012.09.039"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2014.12.023"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2006.02.056"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.05.091"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2011.01.060"},{"key":"e_1_3_4_13_2","first-page":"687","article-title":"Hybrid repair of aortic aneurysms and dissections: the European perspective","volume":"38","author":"Chiesa R","year":"2011","unstructured":"Chiesa R, Tshomba Y, Logaldo D, Civilini E, Bertoglio L, Melissano G. 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