Acute type B dissection: endovascular repair or open surgery?

Acute dissection of the descending thoracic aorta is often a life threatening disease. If complicated by rupture or organ malperfusion, immediate invasive treatment is mandatory to prevent death. Open surgery by interposition grafting or visceral fenestration is complex and associated with high morbidity and mortality. The introduction of endovascular stentgraft repair has offered a minimally invasive option to this patient group. This review aims to highlight the underlying pathophysiology and epidemiology of complex aortic dissection as well as its treatment.