Diagnosis and treatment of uncomplicated type B aortic dissection. (December 2016)

• Record Type: Journal Article
• Authors: Cooper, Michol; Hicks, Caitlin; Ratchford, Elizabeth V; Salameh, Maya J; Malas, Mahmoud
• Is Part Of: Vascular medicine. Volume 21:Number 6(2016:Dec.)
• Page Start: 547
• Page End: 552
• Publication Date: 2016-12
• Subjects: aorta -- aortic diseases -- type B aortic dissection -- best medical therapy -- thoracic endovascular aortic repair (TEVAR); Blood-vessels -- Diseases -- Periodicals; Peripheral vascular diseases -- Periodicals; Vascular Diseases -- Periodicals; Vaisseaux sanguins -- Maladies -- Périodiques; Maladies vasculaires périphériques -- Périodiques; 616.13
• DOI: 10.1177/1358863X16643601
• Languages: English
• ISSNs: 1358-863X

Abstract

A type B dissection involves the aorta distal to the subclavian artery, and accounts for 25–40% of aortic dissections. Approximately 75% of these are uncomplicated with no malperfusion or ischemia. Multiple consensus statements recommend thoracic endovascular aortic repair (TEVAR) as the treatment of choice for acute complicated type B aortic dissections, while uncomplicated type B dissections are traditionally treated with medical management alone, including strict blood pressure control, as open repairs have a prohibitively high morbidity of up to 31%. However, with medical treatment alone, the morbidity, including aneurysm degeneration of the affected segment, is 30%, and mortality is 10% over 5 years. For both chronic and acute uncomplicated type B aortic dissections, emerging evidence supports the use of both best medical therapy and TEVAR. This paper reviews the current diagnosis and treatment of uncomplicated type B aortic dissections.