Treatment of uncomplicated type B aortic dissection
- PMID: 27921203
- DOI: 10.1007/s11748-016-0734-0
Treatment of uncomplicated type B aortic dissection
Abstract
Hospital mortality after the replacement of chronic type B aortic dissection is around 8-10% and adverse outcomes include paraplegia and stroke. However, the level of evidence for indication of thoracic endovascular aortic repair (TEVAR) for type B chronic aortic dissection is Class IIa. Results of the INSTEAD-XL trial have verified that preemptive TEVAR for uncomplicated type B aortic dissection improves prognosis. The indication for this procedure is reportedly a maximum aortic diameter >40 mm during the acute phase and a patent primary entry site in the thoracic aorta, while the optimal timing for TEVAR would be the subacute phase, from 2 weeks to 3-6 months after onset. Prevention of chronic type B aortic dissection with aneurysmal degeneration and attainment of aortic remodeling with preemptive TEVAR are needed to free patients from the need for long-term strict control of blood pressure and periodic follow-ups involving radiological exposure and to avoid the eventual need for extensive open surgery.
Keywords: Aortic dissection; TEVAR; Uncomplicated dissection.
Comment in
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Preemptive endovascular treatment of uncomplicated Stanford Type B aortic dissection.J Thorac Dis. 2018 Nov;10(Suppl 33):S3862-S3864. doi: 10.21037/jtd.2018.09.120. J Thorac Dis. 2018. PMID: 30631499 Free PMC article. No abstract available.