Treatment of the Chronic Type B Aortic Dissection: The Pro-endovascular Argument

Although thoracic endovascular aortic repair (TEVAR) is the standard of care in acute complicated type B dissections, its role in chronic type B dissections remains controversial. This controversy stems from anatomical differences between acute and chronic dissections, such as a thicker intimal clap and improved results in descending aortic replacement. However, despite these important differences, there has been accumulating evidence on the safety and efficacy of TEVAR in chronic type B aortic dissections, especially when considering the alternative of open surgical repair, which is associated with significantly higher morbidity and in many hands also higher mortality. Herein, we discuss the evidence in the literature highlighting TEVAR's safety and efficacy in this setting.