Proximal stent graft combined with distal bare stent vs. conventional thoracic endovascular aortic repair in the treatment of complicated Stanford type B aortic dissection: a systematic review and meta-analysis

作者：Peng Lin, Shouji Qiu, Chengkai Hu, Yuchong Zhang, Enci Wang, Fandi Mo, Weiguo Fu, Lixin Wang · 发表于：Journal of Thoracic Disease · 年份：2025 · DOI：10.21037/jtd-2025-1697 · 被引用次数：2 · 研究领域：Aortic Disease and Treatment Approaches、Aortic aneurysm repair treatments、Congenital Heart Disease Studies

Background: The combination of a proximal stent graft (PSG) and a distal bare stent (DBS) has a number of advantages over standard thoracic endovascular aortic repair (TEVAR) in the treatment of complicated Stanford type B aortic dissection (TBAD). However, direct comparisons between these two treatment approaches remain limited. This meta-analysis aimed to compare the efficacy of these techniques in the treatment of complicated Stanford TBAD. Methods: The Cochrane Library, Embase, PubMed, and Web of Science databases were searched using the following key terms: "provisional extension to induce complete attachment technique", "petticoat", "restrictive stent", "protective stent", "bare stent", and "aortic dissection". All articles relevant to the topic were included in the meta-analysis. The following variables were compared between the two approaches: aortic-related mortality (ARM), false lumen (FL) thrombosis, and complications, such as endoleak, aortic rupture, paraplegia or paraparesis, stroke, renal failure, retrograde dissection, conversion to open repair, reintervention, and stent graft-induced new entry (SINE). Results: A total of 15 studies comprising 1,462 patients were included in the meta-analysis. Of the patients, 635 received a bare stent (the BS group) and 827 received a standard TEVAR (the non-BS group). There were no statistically significant differences between the two groups in terms of the 30-day ARM rate [risk ratio (RR): 0.59; 95% confidence interval (CI)...