Acute type B aortic dissection: current management strategies

Curr Opin Cardiol. 2011 Nov;26(6):488-93. doi: 10.1097/HCO.0b013e32834a6fcc.

Abstract

Purpose of review: Endovascular techniques are increasingly employed to treat patients with acute and chronic diseases of the thoracic aorta. This review focuses on current indication and results of thoracic endovascular stent-graft repair in patients with acute type B aortic dissection.

Recent findings: In patients with type B acute dissections, endovascular treatment should be considered in the presence of complications such as impending rupture, malperfusion, aneurysmal expansion, and uncontrolled pain or blood pressure. No data exist showing improved outcomes after prophylactic endovascular repair of uncomplicated acute dissections. Thus, primary treatment of asymptomatic patients remains medical.

Summary: Endovascular stent-graft repair of complicated type B acute dissection is associated with favorable short-term and mid-term results. Longer-term follow-up is warranted to assess its durability and potential progression of the disease at the downstream aorta.

Publication types

  • Review

MeSH terms

  • Aorta, Thoracic / pathology*
  • Aorta, Thoracic / surgery
  • Aortic Aneurysm, Thoracic / drug therapy
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Aneurysm, Thoracic / therapy
  • Aortic Dissection / drug therapy
  • Aortic Dissection / surgery*
  • Aortic Dissection / therapy
  • Endovascular Procedures / instrumentation
  • Endovascular Procedures / methods*
  • Humans
  • Prognosis
  • Stents
  • Treatment Outcome