{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:01:37Z","timestamp":1790773297386,"version":"4.1.0"},"reference-count":62,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Angiology"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:p>\n                    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;\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200964.6%) 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;\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20098.7%). Paraplegia rates were comparable (RR: 0.88; 95% CI: 0.53-1.47;\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200922.7%). Despite the observed moderate to high heterogeneity among most studies (\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200930%-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.\n                  <\/jats:p>","DOI":"10.1177\/00033197251392660","type":"journal-article","created":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T06:58:40Z","timestamp":1765609120000},"page":"1235-1254","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Open Surgical Versus Endovascular Repair for Type B Aortic Dissection: Umbrella Review and Meta-Analysis"],"prefix":"10.1177","volume":"77","author":[{"given":"Hassan","family":"Al-Thani","sequence":"first","affiliation":[{"name":"Department of Surgery, Trauma, and Vascular Surgery, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5199-744X","authenticated-orcid":false,"given":"Osamah","family":"Alrawi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Elmenyar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Bah\u00e7e\u015fehir University, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mashhood","family":"Naduvilekandy","sequence":"additional","affiliation":[{"name":"Department of Trauma &amp; Vascular Surgery, Clinical Research, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0681-6717","authenticated-orcid":false,"given":"Shams O.","family":"Alkhateeb","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waqar","family":"Mogassabi","sequence":"additional","affiliation":[{"name":"College of Medicine, Qatar University, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lama","family":"Alkahlout","sequence":"additional","affiliation":[{"name":"College of Medicine, Qatar University, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2584-953X","authenticated-orcid":false,"given":"Ayman","family":"El-Menyar","sequence":"additional","affiliation":[{"name":"Department of Trauma &amp; Vascular Surgery, Clinical Research, Hamad Medical Corporation, Doha, Qatar"},{"name":"Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.2174\/1573403X16666201014142930"},{"key":"e_1_3_4_3_2","volume-title":"StatPearls","author":"Levy D.","year":"2025","unstructured":"Levy D. 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