Advances in management of aortic arch in type A aortic dissection_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

AILIYAER Ainiwaer ¹ ,  MAIMAITIAILI Azezi ²

1. Graduate School of Xinjiang Medical University, Urumqi 830017, P. R. China;
2. Department of Cardiac Surgery, Xinjiang Uygur Autonomous Region People’s Hospital, Urumqi 830001, P. R. China;

Corresponding?author：

MAIMAITIAILI Azezi, Email: 12090807@qq.com

Keywords：

aortic dissection; aortic arch management; open surgery; endovascular repair; hybrid procedures

DOI：

10.7507/1007-9424.202506016

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To review current research on aortic arch management strategies in type A aortic dissection (TAAD) and provide a reference for surgical decision-making. Methods A comprehensive literature search was conducted on aortic arch management techniques globally. Results Current research shows three managment for type A aortic dissection surgical startegies:open surgery remains the gold standard but is associated with elevated perioperative mortality and significant postoperative complication rates;endovascular repair,while demonstrating reduced complication incidence, presents substantial technical challenges that hinder widespread clinical adoption;Hybrid procedures exhibit lower acute complication rates, yet long-term outcomes remain uncertain. Conclusions As one of the most lethal emergencies of cardiovascular surgery , TAAD requires immediate intervention. While open surgery is the current gold standard, it presents clinical challenges including elevated mortality and morbidity. Future research must focus on reducing operative duration without compromising success rates.

1.	Zhu Y, Lingala B, Baiocchi M, et al. Type A aortic dissection—experience over 5 decades: JACC historical breakthroughs in perspective. J Am Coll Cardiol, 2020, 76(14): 1703-1713.
2.	Obel LM, Lindholt JS, Lasota AN, et al. Clinical characteristics, incidences, and mortality rates for type A and B aortic dissections: a nationwide Danish population-based cohort study from 1996 to 2016. Circulation, 2022, 146(25): 1903-1917.
3.	Mori Y, Hirose H, Takagi H, et al. Aortic arch repair for Stanford type A aortic dissection with distal anastomosis to the proximal level of the distal aortic arch. J Thorac Cardiovasc Surg, 2003, 126(2): 415-419.
4.	Harris KM, Nienaber CA, Peterson MD, et al. Early mortality in type A acute aortic dissection: insights from the international registry of acute aortic dissection. JAMA Cardiol, 2022, 7(10): 1009-1015.
5.	Marquis KM, Naeem M, Rajput MZ, et al. CT of postoperative repair of the ascending aorta and aortic arch. Radiographics, 2021, 41(5): 1300-1320.
6.	Benedetto U, Dimagli A, Kaura A, et al. Determinants of outcomes following surgery for type A acute aortic dissection: the UK national adult cardiac surgical audit. Eur Heart J, 2021, 43(1): 44-52.
7.	Vervoort D, An KR, Deng MX, et al. The call for the “Interventional/Hybrid” aortic surgeon: open, endovascular, and hybrid therapies of the aortic arch. Can J Cardiol, 2024, 40(3): 478-495.
8.	Spath P, Campana F, Tsilimparis N, et al. Outcomes of fenestrated and branched endografts for partial and total endovascular repair of the aortic arch—a systematic review and meta-analysis. Eur J Vasc Endovasc Surg, 2024, 67(1): 106-116.
9.	Helder MRK, Schaff HV, Day CN, et al. Regional and temporal trends in the outcomes of repairs for acute type A aortic dissections. Ann Thorac Surg, 2020, 109(1): 26-33.
10.	Hughes GC, Chen EP, Browndyke JN, et al. Cognitive effects of body temperature during hypothermic circulatory arrest trial (GOT ICE): a randomized clinical trial comparing outcomes after aortic arch surgery. Circulation, 2024, 149(9): 658-668.
11.	Sun L, Qi R, Zhu J, et al. Total arch replacement combined with stented elephant trunk implantation: a new “standard” therapy for type a dissection involving repair of the aortic arch?. Circulation, 2011, 123(9): 971-978.
12.	馮麗, 田學麗, 王學廷, 等. MSCT血管成像對主動脈弓分支變異的解剖學研究及臨床應用. 實用放射學雜志, 2014, 30(3): 430-433.
13.	Aizawa K, Kawahito K, Misawa Y. Long-term outcomes of tear-oriented ascending/hemiarch replacements for acute type A aortic dissection. Gen Thorac Cardiovasc Surg, 2016, 64(7): 403-408.
14.	Heuts S, Adriaans BP, Kawczynski MJ, et al. Editor’s choice—Extending aortic replacement beyond the proximal arch in acute type A aortic dissection: a meta-analysis of short term outcomes and long term actuarial survival. Eur J Vasc Endovasc Surg, 2022, 63(5): 674-687.
15.	Norton EL, Wu X, Kim KM, et al. Is hemiarch replacement adequate in acute type A aortic dissection repair in patients with arch branch vessel dissection without cerebral malperfusion?. J Thorac Cardiovasc Surg, 2021, 161(3): 873-884.
16.	Borst HG, Walterbusch G, Schaps D. Extensive aortic replacement using “elephant trunk” prosthesis. Thorac Cardiovasc Surg, 1983, 31(1): 37-40.
17.	Crawford ES, Coselli JS, Svensson LG, et al. Diffuse aneurysmal disease (chronic aortic dissection, Marfan, and mega aorta syndromes) and multiple aneurysm. Treatment by subtotal and total aortic replacement emphasizing the elephant trunk operation. Ann Surg, 1990, 211(5): 521-537.
18.	Watanuki H, Ogino H, Minatoya K, et al. Is emergency total arch replacement with a modified elephant trunk technique justified for acute type A aortic dissection?. Ann Thorac Surg, 2007, 84(5): 1585-1591.
19.	Inoue Y, Matsuda H, Omura A, et al. Comparative study of the frozen elephant trunk and classical elephant trunk techniques to supplement total arch replacement for acute type A aortic dissection?. Eur J Cardiothorac Surg, 2019, 56(3): 579-586.
20.	Kato M, Ohnishi K, Kaneko M, et al. New graft-implanting method for thoracic aortic aneurysm or dissection with a stented graft. Circulation, 1996, 94(9 Suppl): Ⅱ188-Ⅱ193. doi: 10.1159/000108060.
21.	Mizuno T, Toyama M, Tabuchi N, et al. Stented elephant trunk procedure combined with ascending aorta and arch replacement for acute type A aortic dissection. Eur J Cardiothorac Surg, 2002, 22(4): 504-509.
22.	孫立忠, 劉志剛, 常謙, 等. 主動脈弓替換加支架 “象鼻” 手術治療 Stanford A 型主動脈夾層. 中華外科雜志, 2004, 42(13): 812-816.
23.	Zhang K, Qiu J, Wu J, et al. Long-term outcomes in total arch replacement combined with frozen elephant trunk for acute type A aortic dissection. J Thorac Cardiovasc Surg, 2025, 170(4): 994-1005.
24.	Tian DH, Ha H, Joshi Y, et al. Long-term outcomes of the frozen elephant trunk procedure: a systematic review. Ann Cardiothorac Surg, 2020, 9(3): 144-151.
25.	Preventza O, Liao JL, Olive JK, et al. Neurologic complications after the frozen elephant trunk procedure: a meta-analysis of more than 3000 patients. J Thorac Cardiovasc Surg, 2020, 160(1): 20-33.
26.	Mazzolai L, Teixido-Tura G, Lanzi S, et al. 2024 ESC guidelines for the management of peripheral arterial and aortic diseases. Eur Heart J, 2024, 45(36): 3538-3700.
27.	陳良萬, 盧琳, 戴小幅, 等. 單分支支架血管植入技術在急性A型主動脈夾層全弓替換加支架象鼻植入術中的應用. 中華醫學雜志, 2011, 91(48): 3435-3437.
28.	孫勇新, 賴顥, 張致琦, 等. Fontus 術中支架在急性A型主動脈夾層中的應用. 中華血管外科雜志, 2018, 3(2): 78-83.
29.	Chen LW, Wu XJ, Dai XF, et al. A self-adaptive triple-branched stent graft for arch repair during open type A dissection surgery. J Thorac Cardiovasc Surg, 2015, 149(5): 1278-1283.
30.	嚴亮亮, 陳銀海, 陳良萬. 三分支支架血管重建主動脈弓的中遠期效果. 學創新, 2017, 14(33): 32-35.
31.	Di Bartolomeo R, Pantaleo A, Berretta P, et al. Frozen elephant trunk surgery in acute aortic dissection. J Thorac Cardiovasc Surg, 2015, 149(2 Suppl): S105-S109. doi: 10.1016/j.jtcvs.2014.07.098.
32.	戴路, 邱家偉, 馬明星, 等. 應用一體化免縫合帶支架人工血管系統治療主動脈夾層. 中華醫學雜志, 2021, 101(12): 872-877.
33.	蔣斌, 劉永春, 鄭曉宇, 等. 免縫合技術在主動脈疾病手術中的運用. 血管與腔內血管外科雜志, 2024, 10(5): 623-627.
34.	鄭曉宇, 蔣斌, 葉仕高, 等. 免縫合技術治療急性A型主動脈夾層. 中華胸心血管外科雜志, 2024, 40(8): 459-463.
35.	靳凱悅, 喬環宇, 李曉南, 等. 腋股動脈聯合插管在主動脈夾層孫氏手術中的應用. 中華胸心血管外科雜志, 2019, 35(11): 680-683.
36.	Takagi H, Umemoto T; ALICE Group. A meta-analysis of total arch replacement with frozen elephant trunk in acute type A aortic dissection. Vasc Endovascular Surg, 2016, 50(1): 33-46.
37.	Norton EL, Wu X, Kim KM, et al. Unilateral is comparable to bilateral antegrade cerebral perfusion in acute type A aortic dissection repair. J Thorac Cardiovasc Surg, 2020, 160(3): 617-625.
38.	Qiu J, Wu J, Xie E, et al. Surgical management and outcomes of the aortic root in acute type A aortic dissection. Ann Thorac Surg, 2020, 110(1): 136-143.
39.	蔣小浪, 董智慧, 符偉國. 腔內修復治療Stanford A型主動脈夾層的現狀與挑戰. 中華外科雜志, 2023, 61(12): 1046-1050.
40.	Ferraresi M, Katsarou M, Luigi Molinari AC, et al. Endovascular repair of ascending aortic pathologies in patients unfit for open surgery: case series and literature review. J Vasc Surg Cases Innov Tech, 2024, 10(3): 101455. doi: 10.1016/j.jvscit.2024.101455.
41.	Yuan X, Mitsis A, Mozalbat D, et al. Alternative management of proximal aortic dissection: concept and application. Indian J Thorac Cardiovasc Surg, 2022, 38(Suppl 1): 183-192.
42.	Shigihara S, Shirakabe A, Okazaki H, et al. Successful treatment of a patient with type-A acute aortic dissection with emergent percutaneous coronary intervention and thoracic endovascular aortic repair under percutaneous cardiopulmonary support: a case report. Eur Heart J Case Rep, 2022, 6(9): ytac344. doi: 10.1093/ehjcr/ytac344. doi: 10.1093/ehjcr/ytac344. doi: 10.1093/ehjcr/ytac344.doi:10.1093/ehjcr/ytac344.
43.	Uchida T, Kuroda Y, Yamashita A, et al. Clinical experience of endovascular stent-graft treatment for stanford type A acute aortic dissection. Kyobu Geka, 2019, 72(12): 976-983.
44.	Nagashima H, Sugiyama T, Kondo N, et al. Successful application of angioembolization and thoracic endovascular aortic repair (TEVAR) in a retrograde type-A acute aortic dissection with polytrauma. Trauma Case Rep, 2021, 37: 100571. doi: 10.1016/j.tcr.2021.100571.
45.	Muetterties CE, Conklin JH, Moser GW, et al. Right axillary artery cannulation for endovascular repair of an acute type A aortic dissection. Innovations (Phila), 2017, 12(2): 140-143.
46.	Canaud L, Morishita K, Gandet T, et al. Homemade fenestrated stent-graft for thoracic endovascular aortic repair of zone 2 aortic lesions. J Thorac Cardiovasc Surg, 2018, 155(2): 488-493.
47.	Qin J, Zhao Z, Liu G, et al. In situ diode laser fenestration of aortic arch stent grafts during thoracic endovascular aortic repair of Stanford type A aortic dissection. EuroIntervention, 2019, 14(18): e1854-e1860. doi: 10.4244/EIJ-D-18-00710.
48.	Ujihira K, Kemmochi R, Matsumoto T, et al. Sandwich technique for endovascular repair of type A aortic dissection following stent graft with an inner branch in the ascending aorta. J Vasc Surg Cases Innov Tech, 2025, 11(2): 101735. doi: 10.1016/j.jvscit.2025.101735.
49.	De Freitas S, Rossi MJ, Abramowitz SD, et al. Systematic review and meta-analysis of endovascular interventions for Stanford type A aortic dissection. J Vasc Surg, 2021, 74(5): 1721-1731.
50.	Ahmed Y, Houben IB, Figueroa CA, et al. Endovascular ascending aortic repair in type A dissection: a systematic review. J Card Surg, 2021, 36(1): 268-279.
51.	國家心血管病專家委員會血管外科專業委員會. 雜交技術治療累及弓部主動脈病變的中國專家共識. 中國循環雜志, 2020, 35(2): 124-130.
52.	Czerny M, Pacini D, Aboyans V, et al. Current options and recommendations for the use of thoracic endovascular aortic repair in acute and chronic thoracic aortic disease: an expert consensus document of the European Society for Cardiology (ESC) Working Group of Cardiovascular Surgery, the ESC Working Group on Aorta and Peripheral Vascular Diseases, the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg, 2021, 59(1): 65-73.
53.	Sule J, Chua CR, Teo C, et al. Hybrid type Ⅱ and frozen elephant trunk in acute Stanford type A aortic dissections. Scand Cardiovasc J, 2022, 56(1): 91-99.
54.	Takayama H, Hohri Y, Brinster DR, et al. Open, endovascular or hybrid repair of aortic arch disease: narrative review of diverse strategies with diverse options. Eur J Cardiothorac Surg, 2024, 65(6): ezae179. doi: 10.1093/ejcts/ezae179.

1. Zhu Y, Lingala B, Baiocchi M, et al. Type A aortic dissection—experience over 5 decades: JACC historical breakthroughs in perspective. J Am Coll Cardiol, 2020, 76(14): 1703-1713.
2. Obel LM, Lindholt JS, Lasota AN, et al. Clinical characteristics, incidences, and mortality rates for type A and B aortic dissections: a nationwide Danish population-based cohort study from 1996 to 2016. Circulation, 2022, 146(25): 1903-1917.
3. Mori Y, Hirose H, Takagi H, et al. Aortic arch repair for Stanford type A aortic dissection with distal anastomosis to the proximal level of the distal aortic arch. J Thorac Cardiovasc Surg, 2003, 126(2): 415-419.
4. Harris KM, Nienaber CA, Peterson MD, et al. Early mortality in type A acute aortic dissection: insights from the international registry of acute aortic dissection. JAMA Cardiol, 2022, 7(10): 1009-1015.
5. Marquis KM, Naeem M, Rajput MZ, et al. CT of postoperative repair of the ascending aorta and aortic arch. Radiographics, 2021, 41(5): 1300-1320.
6. Benedetto U, Dimagli A, Kaura A, et al. Determinants of outcomes following surgery for type A acute aortic dissection: the UK national adult cardiac surgical audit. Eur Heart J, 2021, 43(1): 44-52.
7. Vervoort D, An KR, Deng MX, et al. The call for the “Interventional/Hybrid” aortic surgeon: open, endovascular, and hybrid therapies of the aortic arch. Can J Cardiol, 2024, 40(3): 478-495.
8. Spath P, Campana F, Tsilimparis N, et al. Outcomes of fenestrated and branched endografts for partial and total endovascular repair of the aortic arch—a systematic review and meta-analysis. Eur J Vasc Endovasc Surg, 2024, 67(1): 106-116.
9. Helder MRK, Schaff HV, Day CN, et al. Regional and temporal trends in the outcomes of repairs for acute type A aortic dissections. Ann Thorac Surg, 2020, 109(1): 26-33.
10. Hughes GC, Chen EP, Browndyke JN, et al. Cognitive effects of body temperature during hypothermic circulatory arrest trial (GOT ICE): a randomized clinical trial comparing outcomes after aortic arch surgery. Circulation, 2024, 149(9): 658-668.
11. Sun L, Qi R, Zhu J, et al. Total arch replacement combined with stented elephant trunk implantation: a new “standard” therapy for type a dissection involving repair of the aortic arch?. Circulation, 2011, 123(9): 971-978.
12. 馮麗, 田學麗, 王學廷, 等. MSCT血管成像對主動脈弓分支變異的解剖學研究及臨床應用. 實用放射學雜志, 2014, 30(3): 430-433.
13. Aizawa K, Kawahito K, Misawa Y. Long-term outcomes of tear-oriented ascending/hemiarch replacements for acute type A aortic dissection. Gen Thorac Cardiovasc Surg, 2016, 64(7): 403-408.
14. Heuts S, Adriaans BP, Kawczynski MJ, et al. Editor’s choice—Extending aortic replacement beyond the proximal arch in acute type A aortic dissection: a meta-analysis of short term outcomes and long term actuarial survival. Eur J Vasc Endovasc Surg, 2022, 63(5): 674-687.
15. Norton EL, Wu X, Kim KM, et al. Is hemiarch replacement adequate in acute type A aortic dissection repair in patients with arch branch vessel dissection without cerebral malperfusion?. J Thorac Cardiovasc Surg, 2021, 161(3): 873-884.
16. Borst HG, Walterbusch G, Schaps D. Extensive aortic replacement using “elephant trunk” prosthesis. Thorac Cardiovasc Surg, 1983, 31(1): 37-40.
17. Crawford ES, Coselli JS, Svensson LG, et al. Diffuse aneurysmal disease (chronic aortic dissection, Marfan, and mega aorta syndromes) and multiple aneurysm. Treatment by subtotal and total aortic replacement emphasizing the elephant trunk operation. Ann Surg, 1990, 211(5): 521-537.
18. Watanuki H, Ogino H, Minatoya K, et al. Is emergency total arch replacement with a modified elephant trunk technique justified for acute type A aortic dissection?. Ann Thorac Surg, 2007, 84(5): 1585-1591.
19. Inoue Y, Matsuda H, Omura A, et al. Comparative study of the frozen elephant trunk and classical elephant trunk techniques to supplement total arch replacement for acute type A aortic dissection?. Eur J Cardiothorac Surg, 2019, 56(3): 579-586.
20. Kato M, Ohnishi K, Kaneko M, et al. New graft-implanting method for thoracic aortic aneurysm or dissection with a stented graft. Circulation, 1996, 94(9 Suppl): Ⅱ188-Ⅱ193. doi: 10.1159/000108060.
21. Mizuno T, Toyama M, Tabuchi N, et al. Stented elephant trunk procedure combined with ascending aorta and arch replacement for acute type A aortic dissection. Eur J Cardiothorac Surg, 2002, 22(4): 504-509.
22. 孫立忠, 劉志剛, 常謙, 等. 主動脈弓替換加支架 “象鼻” 手術治療 Stanford A 型主動脈夾層. 中華外科雜志, 2004, 42(13): 812-816.
23. Zhang K, Qiu J, Wu J, et al. Long-term outcomes in total arch replacement combined with frozen elephant trunk for acute type A aortic dissection. J Thorac Cardiovasc Surg, 2025, 170(4): 994-1005.
24. Tian DH, Ha H, Joshi Y, et al. Long-term outcomes of the frozen elephant trunk procedure: a systematic review. Ann Cardiothorac Surg, 2020, 9(3): 144-151.
25. Preventza O, Liao JL, Olive JK, et al. Neurologic complications after the frozen elephant trunk procedure: a meta-analysis of more than 3000 patients. J Thorac Cardiovasc Surg, 2020, 160(1): 20-33.
26. Mazzolai L, Teixido-Tura G, Lanzi S, et al. 2024 ESC guidelines for the management of peripheral arterial and aortic diseases. Eur Heart J, 2024, 45(36): 3538-3700.
27. 陳良萬, 盧琳, 戴小幅, 等. 單分支支架血管植入技術在急性A型主動脈夾層全弓替換加支架象鼻植入術中的應用. 中華醫學雜志, 2011, 91(48): 3435-3437.
28. 孫勇新, 賴顥, 張致琦, 等. Fontus 術中支架在急性A型主動脈夾層中的應用. 中華血管外科雜志, 2018, 3(2): 78-83.
29. Chen LW, Wu XJ, Dai XF, et al. A self-adaptive triple-branched stent graft for arch repair during open type A dissection surgery. J Thorac Cardiovasc Surg, 2015, 149(5): 1278-1283.
30. 嚴亮亮, 陳銀海, 陳良萬. 三分支支架血管重建主動脈弓的中遠期效果. 學創新, 2017, 14(33): 32-35.
31. Di Bartolomeo R, Pantaleo A, Berretta P, et al. Frozen elephant trunk surgery in acute aortic dissection. J Thorac Cardiovasc Surg, 2015, 149(2 Suppl): S105-S109. doi: 10.1016/j.jtcvs.2014.07.098.
32. 戴路, 邱家偉, 馬明星, 等. 應用一體化免縫合帶支架人工血管系統治療主動脈夾層. 中華醫學雜志, 2021, 101(12): 872-877.
33. 蔣斌, 劉永春, 鄭曉宇, 等. 免縫合技術在主動脈疾病手術中的運用. 血管與腔內血管外科雜志, 2024, 10(5): 623-627.
34. 鄭曉宇, 蔣斌, 葉仕高, 等. 免縫合技術治療急性A型主動脈夾層. 中華胸心血管外科雜志, 2024, 40(8): 459-463.
35. 靳凱悅, 喬環宇, 李曉南, 等. 腋股動脈聯合插管在主動脈夾層孫氏手術中的應用. 中華胸心血管外科雜志, 2019, 35(11): 680-683.
36. Takagi H, Umemoto T; ALICE Group. A meta-analysis of total arch replacement with frozen elephant trunk in acute type A aortic dissection. Vasc Endovascular Surg, 2016, 50(1): 33-46.
37. Norton EL, Wu X, Kim KM, et al. Unilateral is comparable to bilateral antegrade cerebral perfusion in acute type A aortic dissection repair. J Thorac Cardiovasc Surg, 2020, 160(3): 617-625.
38. Qiu J, Wu J, Xie E, et al. Surgical management and outcomes of the aortic root in acute type A aortic dissection. Ann Thorac Surg, 2020, 110(1): 136-143.
39. 蔣小浪, 董智慧, 符偉國. 腔內修復治療Stanford A型主動脈夾層的現狀與挑戰. 中華外科雜志, 2023, 61(12): 1046-1050.
40. Ferraresi M, Katsarou M, Luigi Molinari AC, et al. Endovascular repair of ascending aortic pathologies in patients unfit for open surgery: case series and literature review. J Vasc Surg Cases Innov Tech, 2024, 10(3): 101455. doi: 10.1016/j.jvscit.2024.101455.
41. Yuan X, Mitsis A, Mozalbat D, et al. Alternative management of proximal aortic dissection: concept and application. Indian J Thorac Cardiovasc Surg, 2022, 38(Suppl 1): 183-192.
42. Shigihara S, Shirakabe A, Okazaki H, et al. Successful treatment of a patient with type-A acute aortic dissection with emergent percutaneous coronary intervention and thoracic endovascular aortic repair under percutaneous cardiopulmonary support: a case report. Eur Heart J Case Rep, 2022, 6(9): ytac344. doi: 10.1093/ehjcr/ytac344. doi: 10.1093/ehjcr/ytac344. doi: 10.1093/ehjcr/ytac344.doi:10.1093/ehjcr/ytac344.
43. Uchida T, Kuroda Y, Yamashita A, et al. Clinical experience of endovascular stent-graft treatment for stanford type A acute aortic dissection. Kyobu Geka, 2019, 72(12): 976-983.
44. Nagashima H, Sugiyama T, Kondo N, et al. Successful application of angioembolization and thoracic endovascular aortic repair (TEVAR) in a retrograde type-A acute aortic dissection with polytrauma. Trauma Case Rep, 2021, 37: 100571. doi: 10.1016/j.tcr.2021.100571.
45. Muetterties CE, Conklin JH, Moser GW, et al. Right axillary artery cannulation for endovascular repair of an acute type A aortic dissection. Innovations (Phila), 2017, 12(2): 140-143.
46. Canaud L, Morishita K, Gandet T, et al. Homemade fenestrated stent-graft for thoracic endovascular aortic repair of zone 2 aortic lesions. J Thorac Cardiovasc Surg, 2018, 155(2): 488-493.
47. Qin J, Zhao Z, Liu G, et al. In situ diode laser fenestration of aortic arch stent grafts during thoracic endovascular aortic repair of Stanford type A aortic dissection. EuroIntervention, 2019, 14(18): e1854-e1860. doi: 10.4244/EIJ-D-18-00710.
48. Ujihira K, Kemmochi R, Matsumoto T, et al. Sandwich technique for endovascular repair of type A aortic dissection following stent graft with an inner branch in the ascending aorta. J Vasc Surg Cases Innov Tech, 2025, 11(2): 101735. doi: 10.1016/j.jvscit.2025.101735.
49. De Freitas S, Rossi MJ, Abramowitz SD, et al. Systematic review and meta-analysis of endovascular interventions for Stanford type A aortic dissection. J Vasc Surg, 2021, 74(5): 1721-1731.
50. Ahmed Y, Houben IB, Figueroa CA, et al. Endovascular ascending aortic repair in type A dissection: a systematic review. J Card Surg, 2021, 36(1): 268-279.
51. 國家心血管病專家委員會血管外科專業委員會. 雜交技術治療累及弓部主動脈病變的中國專家共識. 中國循環雜志, 2020, 35(2): 124-130.
52. Czerny M, Pacini D, Aboyans V, et al. Current options and recommendations for the use of thoracic endovascular aortic repair in acute and chronic thoracic aortic disease: an expert consensus document of the European Society for Cardiology (ESC) Working Group of Cardiovascular Surgery, the ESC Working Group on Aorta and Peripheral Vascular Diseases, the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg, 2021, 59(1): 65-73.
53. Sule J, Chua CR, Teo C, et al. Hybrid type Ⅱ and frozen elephant trunk in acute Stanford type A aortic dissections. Scand Cardiovasc J, 2022, 56(1): 91-99.
54. Takayama H, Hohri Y, Brinster DR, et al. Open, endovascular or hybrid repair of aortic arch disease: narrative review of diverse strategies with diverse options. Eur J Cardiothorac Surg, 2024, 65(6): ezae179. doi: 10.1093/ejcts/ezae179.

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