Type B Aortic Dissections: Current Guidelines for Treatment

Daniel B Alfson; Sung W Ham

doi:10.1016/j.ccl.2017.03.007

Type B Aortic Dissections: Current Guidelines for Treatment

Cardiol Clin. 2017 Aug;35(3):387-410. doi: 10.1016/j.ccl.2017.03.007. Epub 2017 May 26.

Authors

Daniel B Alfson¹, Sung W Ham²

Affiliations

¹ Division of Vascular Surgery, Department of Surgery, Keck School of Medicine of USC, University of Southern California, 1520 San Pablo Street, HCC II, Suite 4300, Los Angeles, CA 90033-5330, USA.
² Division of Vascular Surgery, Department of Surgery, Keck School of Medicine of USC, University of Southern California, 1520 San Pablo Street, HCC II, Suite 4300, Los Angeles, CA 90033-5330, USA. Electronic address: Sung.Ham@med.usc.edu.

PMID: 28683909
DOI: 10.1016/j.ccl.2017.03.007

Abstract

Stanford type B aortic dissections (TBADs) involve the descending aorta and can present with complications, including malperfusion syndrome or aortic rupture, which are associated with significant morbidity and mortality if left untreated. Clinical diagnosis is straightforward, typically confirmed using CT angiography. Treatment begins with immediate anti-impulse medical therapy. Acute TBAD with complications should be repaired with emergent thoracic endovascular aortic repair (TEVAR). Uncomplicated TBAD with high-risk features should undergo TEVAR in the subacute phase. Open surgical repair is seldom required and reserved only for select cases. It is critical to follow these patients clinically and radiographically in the outpatient setting.

Keywords: False lumen; Remodeling; Stanford type B aortic dissection; TEVAR; Treatment.

Publication types

Review

MeSH terms

Aortic Aneurysm, Thoracic / diagnosis
Aortic Aneurysm, Thoracic / surgery*
Aortic Dissection / diagnosis
Aortic Dissection / surgery*
Blood Vessel Prosthesis Implantation
Disease Progression
Endovascular Procedures / methods
Humans
Practice Guidelines as Topic
Treatment Outcome