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Management of Acute, Complicated Type B Aortic Dissection
Daniel Sheeran1, Luke Wilkins1, Prajeeth Kumar Koyada1
1Department of Radiology, University of Virginia.
Techniques in Vascular and Interventional Radiology
|October 4, 2021
Summary
Acute complicated Type B aortic dissection (TBAD) demands rapid, multidisciplinary care. This review clarifies invasive treatment options like endografts and open repair for improved patient outcomes.
Area of Science:
- Cardiovascular Surgery
- Vascular Medicine
- Thoracic Surgery
Background:
- Acute complicated Type B aortic dissection (TBAD) presents significant morbidity and mortality risks.
- Rapid triage and management are crucial for patients with complicated TBAD.
- Optimal medical, endovascular, and open therapies are available but require careful consideration.
Purpose of the Study:
- To review the clinical presentation and diagnosis of acute complicated TBAD.
- To explain the various invasive therapeutic options, including thoracic endograft placement, aortic fenestration, branch vessel stenting, and open repair.
- To discuss contraindications, expected outcomes, complications, and adjunct therapies for TBAD management.
Main Methods:
- Review of existing literature on acute complicated Type B aortic dissection.
- Analysis of clinical presentations, diagnostic approaches, and therapeutic strategies.
- Evaluation of endovascular and open repair techniques, including their indications and outcomes.
Main Results:
- Advanced endovascular techniques have improved immediate outcomes for acute complicated TBAD.
- The optimal sequencing and selection of invasive therapies remain areas requiring further clarification.
- Understanding complicating features is key to a multidisciplinary management approach.
Conclusions:
- Multidisciplinary evaluation is essential for managing acute complicated TBAD.
- While endovascular interventions have advanced care, patient selection and therapeutic strategies need further research.
- A comprehensive understanding of all treatment modalities is vital for effective TBAD management.
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