Search Strategy and Selection Criteria
A biomedical information specialist performed a comprehensive search on
21 February 2022 in Embase, Medline, Web of Science, Cochrane, and
Google Scholar databases (search terms are available in Supplementary
Material). Two researchers (D.A. and G.T.) independently reviewed
abstracts and full texts based on predefined inclusion/exclusion
criteria. Observational studies, both retrospective and prospective, and
randomized controlled trials (RCTs) that reported outcomes after aortic
arch surgery in adults with a sample size ≥ 10 patients, published in
English, were included. Non-original studies (reviews), case reports,
poster publications, conference presentations, animal studies,
editorials, studies not defining or incomplete reporting of outcome and
data were excluded. Studies had to compare at least two study arms to be
eligible for inclusion in the network meta-analysis. Furthermore,
studies reporting on hybrid aortic arch procedures, other than frozen
elephant trunk, solely redo cases, type B aortic dissections, articles
on exclusively concomitant procedures, mini-sternotomy and all different
approaches other than median sternotomy were excluded. In case of
disagreement, an agreement was negotiated until consensus was reached.
In case of multiple publications on overlapping study populations, the
largest series were included.