CONCLUSION
In the present network meta-analysis, the risk of operative mortality decreased with the use of mild HCA. Furthermore, the use of DHCA was associated with substantial higher risks of postoperative incidence of stroke when compared with the application of moderate-to-mild hypothermia management in combination with selective cerebral perfusion. These outcomes were reinforced by the sensitivity analysis of RCTs and PSM studies. Our findings call attention to and further highlight the unique challenges in selecting and managing temperature in aortic arch surgery. Future prospective high-quality research studies are warranted to allow better outcomes in this complex surgical procedures.