Controlled studies that enrolled patients who received an endovascular device to repair pathologies of the descending thoracic aorta (which included transection, aneurysm and dissection) were eligible for inclusion. Studies were required to compare patients in whom the LSA was intentionally covered with patients in whom the endograft placement did not cover the LSA or who underwent a primary revascularisation procedure such as a carotid-subclavian bypass or transposition.
Outcomes assessed in the review included death, arm ischaemia, vertebrobasilar ischaemia, anterior circulation stroke, transient ischaemic attack, spinal cord ischaemia, myocardial infarction, phrenic nerve paralysis and infection. Definitions of outcomes were reported in the paper. There were no restrictions on sample size or duration of follow-up.
Most of the patients in included studies were male (75%). Mean age was 58 years. A number of different commercial and homemade endografts were employed. Procedures were a mixture of urgent and elective and a variety of indications was represented.
Two reviewers independently assessed studies for inclusion in the review. Disagreements were resolved through consensus or arbitration by a third reviewer.