[Stent Grafting for Aortic Dissection].

Area of Science:

• Cardiovascular Surgery
• Vascular Endovascular Therapy
• Aortic Disease Management

Background:

• Aortic dissection involves a tear in the aorta's inner layer, creating a false lumen.
• Stent grafting aims to redirect blood flow away from the false lumen.
• Management strategies differ significantly between acute and chronic aortic dissections.

Purpose of the Study:

• To evaluate the role and efficacy of stent grafting in managing aortic dissections.
• To discuss the current controversies and indications for stent grafting in chronic aortic dissection.
• To highlight alternative and re-intervention techniques for complex aortic dissection cases.

Main Methods:

• Review of current literature and clinical guidelines on stent grafting for aortic dissection.
• Analysis of outcomes for emergent stent grafting in acute type B aortic dissection.
• Discussion of criteria and techniques for stent grafting in chronic aortic dissection.

Main Results:

• Emergent stent grafting for complicated acute type B aortic dissection is a Class I recommendation.
• Stent grafting for chronic aortic dissection is controversial, with early intervention considered if aortic diameter exceeds 40 mm within 6 months.
• Additional interventions like re-entry stent grafts, candy-plug technique, and double stenting may be required.

Conclusions:

• Stent grafting is effective for acute aortic dissections, particularly for complicated type B.
• Treatment for chronic aortic dissection requires individualized planning, considering anatomical features and potential need for re-interventions.
• Frozen elephant trunk technique offers an alternative for acute type A aortic dissection, irrespective of proximal anatomy.