Endovascular Therapies for Type B Aortic Dissection

Abstract

Aortic dissection is a life-threatening condition resulting from a tear in the intimal layer of the aorta, requiring emergent diagnosis and prompt multi-disciplinary management strategy for best patient outcomes. While type A dissection involving ascending aorta is best managed surgically due to high early mortality, Type B Aortic Dissection (TBAD) involving descending aorta generally has better outcomes with conservative management and medical therapy as a primary strategy is favored. However, there has been a recent paradigm shift in the management of TBAD due to late aneurysmal degeneration of TBAD, increasing morbidity and mortality in the long term. Late surgical intervention can be prevented by early endovascular intervention when combined with optimal medical therapy. In this narrative review, we explore available literature on different endovascular therapies for TBAD in different populations of patients.

Keywords: Type b aortic dissection; acute aortic syndrome; atherosclerotic aortic ulcer; endovascular therapies; thoracic aortic rupture.; thoracic endovascular aortic repair (TEVAR).