{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T07:03:30Z","timestamp":1789715010097,"version":"4.0.1"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,4,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Intraluminal thrombosis (ILT) has been observed in endografts in the thoracic aorta after frozen elephant trunk (FET) for aortic arch pathologies. This study aimed to evaluate the incidence and clinical outcomes associated with ILT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Systematic review of studies reporting incidence of ILT after FET and comparing outcomes of patients with and without ILT. PubMed\/MEDLINE, EMBASE, Web of Science, and Cochrane databases (inception to September 2025) were searched. Single\u2010arm meta\u2010analysis was conducted to determine ILT incidence and 2\u2010arm meta\u2010analyses between groups with ILT and without with a random\u2010effects model to assess patient\u2010relevant outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Five observational studies, including 999 patients, met our eligibility criteria. Pooled incidence of ILT after FET was 9.24% (95% CI, 6.32\u201313.31). Although we did not find statistically significant associations between ILT and postoperative stroke (odds ratio [OR], 0.93 [95% CI, 0.46\u20131.88];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.845), we found statistically significant associations with embolic events (OR, 6.94 [95% CI, 1.01\u201347.46];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.048) and early mortality (OR, 3.59 [95% CI, 1.69\u20137.60];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). We found positive correlations between proportion of female patients in the populations and incidence of ILT (coefficient, 0.08 [95% CI, 0.02\u20130.14];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.011). Meta\u2010regression coefficients were statistically significant for embolic events and female sex (coefficient, 0.12 [95% CI, 0.06\u20130.18];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), aortic aneurysm (coefficient, 0.08 [95% CI, 0.04\u20130.13];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), and mean age (coefficient, 0.66 [95% CI, 0.33\u20130.99];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), which means that associations differ across populations with varying mean levels of these covariates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Because ILT after FET seems to be associated with embolic events and early mortality, close follow\u2010up is warranted\u2014especially for women, older people, and patients with aortic aneurysms\u2014and anticoagulation should be considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047425","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T11:08:19Z","timestamp":1773832099000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Incidence and Outcomes of Intraluminal Frozen Elephant Trunk Stent Graft Thrombosis After Aortic Arch Surgery: Systematic Review and Meta\u2010Analysis"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5356-2996","authenticated-orcid":false,"given":"Michel Pompeu","family":"S\u00e1","sequence":"first","affiliation":[{"name":"Cleveland Clinic Florida","place":["Weston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6954-6114","authenticated-orcid":false,"given":"Leo","family":"Consoli","sequence":"additional","affiliation":[{"name":"School of Medicine of Universidade Federal da Bahia (UFBA)","place":["Salvador, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5901-9935","authenticated-orcid":false,"given":"Gabriel","family":"Neves","sequence":"additional","affiliation":[{"name":"School of Medicine of Universidade Estadual do Par\u00e1 (UEPA)","place":["Bel\u00e9m, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6050-7514","authenticated-orcid":false,"given":"Thiago","family":"Camarotti","sequence":"additional","affiliation":[{"name":"School of Medicine of Universidade de Pernambuco (UPE)","place":["Recife, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Napoli","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Florida","place":["Weston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2570-324X","authenticated-orcid":false,"given":"Nicolas A.","family":"Brozzi","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Florida","place":["Weston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4089-2202","authenticated-orcid":false,"given":"Jose L.","family":"Navia","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Florida","place":["Weston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Polanco","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Florida","place":["Weston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000006933"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezad364"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12196327"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2023.01.014"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2022.08.005"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2022.12.030"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_1_9_2","unstructured":"ROBINS\u2010E Development Group Higgins J Morgan R Rooney A Taylor K Thayer K Silva R Lemeris C Akl A Arroyave W et\u00a0al. Risk of bias in non\u2010randomized studies\u2014of Exposure (ROBINS\u2010E). Launch version 1 June 2022. https:\/\/www.riskofbias.info\/welcome\/robins\u2010e\u2010tool."},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7588"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.2307\/2533446"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjon.2025.05.003"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.921479"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2021.07.226"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.047425","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T06:34:51Z","timestamp":1789713291000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.047425"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,4,7]]}},"alternative-id":["10.1161\/JAHA.125.047425"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.047425","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]},"assertion":[{"value":"2025-10-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e047425"}}