Open surgery versus branched endovascular repair of the aortic arch in residual dissections after type A surgical repair - Summary - MDSpire

Open surgery versus branched endovascular repair of the aortic arch in residual dissections after type A surgical repair

  • By

  • Giovanni Tinelli

  • Simona Sica

  • Nikolaos Tsilimparis

  • Maximilian Pichlmaier

  • Eugenio Neri

  • Aurélien Hostalrich

  • Tilo Kölbel

  • Jonathan Sobocinski

  • Marco Di Eusanio

  • Emanuele Gatta

  • Andres Schanzer

  • Guillaume Guimbretière

  • Diana Giannarelli

  • Ming Hao Guo

  • Yamume Tshomba

  • Massimo Massetti

  • Stéphan Haulon

  • International multicenter post-Dissection Arch Repair Study (DARS) Group

  • Daniel Becker

  • Giuseppe Panuccio

  • Bertrand Marcheix

  • Mario D’Oria

  • Mollynda McArthur

  • Paolo Beretta

  • Petroula Nana

  • Piergiorgio Bruno

  • Renata Kazue Nakahara Rocha

  • Sven Peterss

  • Thibaut Boisroux

  • Thomas Mesnard

  • Xavier Chaufour

  • February 17, 2026

  • 0 min

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Objective:

To compare the outcomes of open arch repair versus arch branched endovascular aortic repair (a-BEVAR) in patients with residual aortic dissection after ascending aorta replacement for acute Stanford type A aortic dissection.

Key Findings:
  • 30-day mortality rate: 3.5% for open arch repair vs. 5.3% for a-BEVAR (P = 0.220).
  • Stroke rate: 5.3% for open arch repair vs. 3.5% for a-BEVAR (P = 0.650).
  • Higher rates of prolonged intubation (28.1% vs. 3.5%; P < 0.001), acute kidney injury (31.6% vs. 8.8%; P = 0.002), and temporary dialysis (22.8% vs. 7.0%; P = 0.002) associated with open arch repair.
  • Median hospital length of stay: 21 days for open arch repair vs. 10 days for a-BEVAR (P < 0.001).
  • No significant difference in long-term mortality (10.5% for open arch repair vs. 12.3% for a-BEVAR; P = 0.770).
Interpretation:

Arch branched endovascular aortic repair (a-BEVAR) offers a less invasive alternative to open arch repair, significantly reducing complications and hospital stays.

Limitations:
  • Retrospective design may introduce selection bias, potentially affecting the generalizability of the results.
  • Limited follow-up duration of 30 months.
Conclusion:

Arch branched endovascular aortic repair (a-BEVAR) is associated with fewer complications compared to open arch repair, suggesting it may be a preferable option for high-risk patients.

Original Source(s)

Open surgery versus branched endovascular repair of the aortic arch in residual dissections after type A surgical repair

  • by Giovanni Tinelli, Simona Sica, Nikolaos Tsilimparis, Maximilian Pichlmaier, Eugenio Neri, Aurélien Hostalrich, Tilo Kölbel, Jonathan Sobocinski, Marco Di Eusanio, Emanuele Gatta, Andres Schanzer, Guillaume Guimbretière, Diana Giannarelli, Ming Hao Guo, Yamume Tshomba, Massimo Massetti, Stéphan Haulon, International multicenter post-Dissection Arch Repair Study (DARS) Group, Daniel Becker, Giuseppe Panuccio, Bertrand Marcheix, Mario D’Oria, Mollynda McArthur, Paolo Beretta, Petroula Nana, Piergiorgio Bruno, Renata Kazue Nakahara Rocha, Sven Peterss, Thibaut Boisroux, Thomas Mesnard, Xavier Chaufour

  • February 17, 2026

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