Perspectives in Vascular Surgery and Endovascular Therapy

 

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Perspectives in Vascular Surgery and Endovascular Therapy, Vol. 19, No. 2, 162-169 (2007)
DOI: 10.1177/1531003507304083

Stent Graft Management of Stable, Uncomplicated Type B Aortic Dissection

Sidney L. Kahn, MD

University of Virginia Health System, Charlottesville, Virginia

Michael D. Dake, MD

University of Virginia Health System, Charlottesville, Virginia, mdd2n{at}virginia.edu

Aortic dissection has an incidence of 2.6 to 3.5 per 100 000 person years. Although the traditional approach has focused on surgical and medical intervention, several studies demonstrate the efficacy of endovascular repair for aortic dissection. Bolstered by a high technical success rate and improved morbidity and mortality relative to its surgical counterpart, endovascular repair has become a first-line treatment for complicated type B aortic dissection. The debate over the optimal approach to uncomplicated type B dissection is more contentious. The consensus remains in support of medical therapy tailored for tight control of hypertension. The poor long-term results of this regimen, with up to 50% mortality at 5 years, have shifted attention to endovascular stent grafting as an alternative. This article reviews the latest research on uncomplicated type B dissection and its treatment, concentrating on endovascular technique, anatomic considerations, timing of intervention, and outcomes. Early research indicates endovascular stent grafting is a promising modality for these patients.

Key Words: type B aortic dissections • endovascular repair • stent graft


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Once Dissected Always Dissected! Can Stent Grafts Change the Natural History of Type B Dissections?: A Report From the International Registry of Acute Aortic Dissection
J. Am. Coll. Cardiol. Intv., August 1, 2008; 1(4): 403 - 404.
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