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Table 2 Clinical characteristics of participants in central repair group and early reperfusion group.DM: diabetes mellitus; COPD: chronic obstructive pulmonary disease; RCCA: right carotid common artery; LCCA: left carotid common artery; BCCA: bilateral common carotid artery; RR: risk ratio; CPB: cardiopulmonary bypass; Acc: aortic cross-clamp; HCA: hypothermic cardiac arrest; ACP: antegrade cerebral perfusion; RCP: retrograde cerebral perfusion

From: Two surgical strategies (early carotid reperfusion vs. Central aortic repair-first) of acute type a aortic dissection complicated with cerebral malperfusion syndrome: a meta-analysis and systematic review

Variable

Central repair, n

(%)

Early reperfusion, n (%)

RR, MD

P

Number of patients

472

86

  

Mean age, years

61.1 ± 17.3

60.9 ± 16.4

0.20(-3.73, 4.13)

0.92

Sex, male

189/322

54/86

0.93(0.78, 1.13)

0.48

Hypertension

187/270

50/68

0.94(0.80, 1.11)

0.47

DM

8/181

5/23

0.20(0.07, 0.57)

0.002

COPD

3/143

1/23

0.48(0.05, 4.44)

0.52

Coronary artery disease

16/234

3/28

0.64(0.20, 2.05)

0.45

Renal insufficiency

3/143

12/58

0.10(0.03, 0.35)

<0.01

Aortic valve insufficiency

6/44

15/50

0.45(0.19, 1.07)

0.07

Organ malperfusion

    

Coronary

36/341

10/61

0.64(0.34, 1.23)

0.18

Mesenteric

30/293

0/28

6.02(0.38, 95.86)

0.20

Limb

64/341

6/68

2.13(0.96, 4.71)

0.06

Kidney

24/182

2/38

2.51(0.62, 10.16)

0.2

Cardiac tamponade

78/391

4/40

1.99(0.77, 5.16)

0.15

Preoperative presentation

    

Coma

79/436

13/60

0.84(0.50, 1.41)

0.50

Hemiplegia

120/257

14/69

2.30(1.42, 3.74)

< 0.001

Neurologic deficit

15/44

14/45

1.10(0.60, 1.99)

0.76

Syncope

15/150

7/23

0.33(0.15, 0.72)

0.005

Hemianopsia

30/207

1/23

3.33(0.48, 23.32)

0.23

Shock

5/44

9/68

0.86(0.31, 2.39)

0.77

Involved artery

    

RCCA

142/248

30/51

0.97(0.76, 1.25)

0.83

LCCA

91/248

12/61

1.87(1.09, 3.18)

0.02

BCCA

9/32

5/70

3.94(1.43, 10.81)

<0.01

Innominate artery

1/16

21/37

0.11(0.02, 0.75)

0.02

Time to surgery, h

8.2 ± 15.3

7.8 ± 5.4

0.4(-1.6, 2.40)

0.7

Surgery procedure

    

Hemiarch

87/396

18/67

0.82(0.53, 1.27)

0.37

Partial arch

2/53

3/35

0.44(0.08, 2.50)

0.35

Total arch

128/396

46/67

0.47(0.38, 0.58)

<0.01

Ascending replacement

43/61

8/51

4.49(2.33, 8.67)

<0.01

Bentall

55/303

26/51

0.36(0.25, 0.51)

<0.01

Valve sparing

1/153

24/51

0.01(0, 0.1)

<0.01

AVR

1/12

11/23

0.17(0.03, 1.19)

0.08

CABG

3/12

10/51

1.27(0.41, 3.93)

0.67

Elephant trunk

39/108

32/51

0.58(0.41, 0.80)

0.001

Arterial cannulation

    

Axillary artery

101/344

15/51

1.00(0.63, 1.57)

0.99

Femoral artery

127/344

35/51

0.54(0.43, 0.68)

<0.01

Carotid artery

4/150

27/32

0.03(0.01, 0.08)

<0.01

Aortic

56/150

1/53

19.79(2.81, 139.41)

0.003

Cerebral perfusion

    

ACP

284/420

86/86

0.68(0.63, 0.73)

<0.01

RCP

110/420

0/86

45.67(2.87, 727.71)

0.007

Lowest temperature, °C

21.7 ± 3.3

25.3 ± 2.4

-3.60(-4.32, -2.88)

<0.01

CPB, min

220.7 ± 94.5

220.3 ± 68.1

0.4(-18.42, 19.22)

0.97

Acc, min

141.3 ± 76.5

117.3 ± 48.5

24(15.48, 32.52)

<0.01

HCA, min

35.1 ± 18.2

39.4 ± 15.7

-4.30(-16.07, 7.47)

0.47