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Endovascular Management of Chronic Type B Aortic Dissection

Anatoly Loskutov1, Monica Cooley2, Matthew Scheidt2

  • 1University of Missouri Kansas City, Division of Vascular and Interventional Radiology, Department of Radiology, Kansas City, MO.

Techniques in Vascular and Interventional Radiology
|October 4, 2021
PubMed

Insights

Chronic type B aortic dissection (cTBAD) management can involve thoracic endovascular aortic repair (TEVAR). This article reviews four cTBAD cases treated with TEVAR, highlighting diverse techniques for this complex aortic condition.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Medical Imaging

Background:

  • Acute uncomplicated type B aortic dissection (aTBAD) typically receives non-operative management focused on blood pressure and heart rate control.
  • Chronic type B aortic dissection (cTBAD) is defined as dissection persisting beyond 3 months post-diagnosis.
  • Monitoring for cTBAD involves regular clinical and imaging follow-up to detect instability, aneurysm formation, or malperfusion.

Purpose of the Study:

  • To present and discuss four cases of chronic type B aortic dissection (cTBAD).
  • To illustrate the application of thoracic endovascular aortic repair (TEVAR) in managing cTBAD.
  • To explore the varying techniques employed during TEVAR for cTBAD.

Main Methods:

  • Case series review of four patients diagnosed with cTBAD.
  • Application of thoracic endovascular aortic repair (TEVAR) as a treatment modality.
  • Analysis of different technical approaches used in TEVAR procedures.

Main Results:

  • Successful management of four cTBAD cases using TEVAR.
  • Demonstration of diverse TEVAR techniques tailored to individual patient anatomy and pathology.
  • Evaluation of dissection stability and potential complications post-TEVAR.

Conclusions:

  • Thoracic endovascular aortic repair (TEVAR) is a viable option for managing chronic type B aortic dissection (cTBAD).
  • The choice of TEVAR technique should be individualized based on patient-specific factors.
  • Further research into optimal TEVAR strategies for cTBAD is warranted.

Keywords:
TEVARchronic type B aortic dissectionendovascular interventionsfalse lumen

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