Studies comparing thoracic endovascular aortic repair (TEVAR) with open repair of BTAI, or studies of at least six participants with acute BTAI treated with TEVAR from a remote access site, were eligible for inclusion in the review. Studies of patients with multiple aetiologies, or studies with multiple treatments from which outcomes of interest could not be extracted separately for patients with BTAI, were excluded. The primary outcomes of interest were survival at 30 days and paraplegia rates. Secondary outcomes included incidence of endoleak (early and late) and access site complications.
Study designs included cohort and case series. A number of different stent-graft devices were reported: AncureAneuRx cuff, Braile, EndoFit, EVita, Excluder, Relay, TAG, Talent, TX1/2, Valient, Vanguard cuff, Zenith and homemade. The mean age in the cohort studies was 40 years in the TEVAR group and 38 years in the operative repair group. The mean injury severity score (ISS) in the cohort studies was 40 for the TEVAR group and 38 for the operative repair group. Mean follow-up was 24 months (range seven to 60 months) in the TEVAR group and 53 (range seven to 72 months) in the operative repair group in the cohort studies and mean follow-up in the case series was 18 months (range three to 36 months). Technical success (defined as successful introduction and deployment of graft without type I or type III endoleak, no significant obstruction and no mortality or surgical conversion at 24 hours) and rate of stroke was also reported, in addition to the primary and secondary outcomes of interest.
The authors did not state how papers were selected for the review or how many reviewers performed the selection.