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Role of Endoluminal Techniques in the Management of Chronic Type B Aortic Dissection

Konstantinos Spanos1, Tilo Kölbel2

  • 1German Aortic Center Hamburg, Department of Vascular Medicine, University Heart Center, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. spanos.kon@gmail.com.

Cardiovascular and Interventional Radiology
|July 1, 2020
PubMed

Insights

Aneurysmal dilatation is the main reason for treating chronic type B aortic dissection (cTBAD). Endovascular repair is a key option for high-risk patients, with ongoing advances in techniques and devices.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Medicine
  • Medical Devices

Background:

  • Aneurysmal dilatation is the most common indication for intervention in chronic type B aortic dissection (cTBAD).
  • International guidelines recommend endovascular repair for patients with moderate to high surgical risk or contraindications to open repair.
  • Significant advancements in endovascular techniques and devices have occurred over the past decade.

Purpose of the Study:

  • To review the current status of endoluminal techniques for managing cTBAD.
  • To discuss various endovascular approaches, including standard thoracic endovascular repair and novel device applications.
  • To cover techniques such as fenestrated and branched aortic devices and false lumen occlusion.

Main Methods:

  • Review of recent literature and guidelines on cTBAD management.
  • Analysis of current endovascular techniques and device innovations.
  • Discussion of treatment strategies for aneurysmal dilatation in cTBAD.

Main Results:

  • Endovascular repair is increasingly utilized for cTBAD, particularly in high-risk populations.
  • New devices and techniques are expanding the applicability of endovascular repair.
  • False lumen occlusion and branched/fenestrated devices offer tailored solutions for complex anatomy.

Conclusions:

  • Endovascular repair represents a significant advancement in managing cTBAD, especially aneurysmal dilatation.
  • Ongoing innovation in devices and techniques continues to improve outcomes for patients with cTBAD.
  • A comprehensive understanding of current endoluminal strategies is crucial for optimal patient care.

Keywords:
Chronic type B dissectionEndovascular repairInner branch deviceRemodelingTEVAR

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