Thoracic Endovascular Aortic Repair for Chronic Type B Aortic Dissection: Pre- and Postprocedural Imaging

Area of Science:

• Vascular Surgery
• Diagnostic Imaging
• Interventional Radiology

Background:

• Aortic dissection is a chronic condition necessitating long-term clinical and imaging follow-up.
• Imaging is crucial for prognosis, surgical planning, and complication monitoring in the endovascular era.
• Chronic dissection presents repair challenges like small true lumens and complex anatomy.

Purpose of the Study:

• To review imaging options for chronic aortic dissection.
• To illustrate endovascular repair techniques for aortic dissection.
• To highlight potential complications associated with these techniques.

Main Methods:

• Review of preprocedural imaging features influencing treatment strategy.
• Description of standard thoracic endovascular aortic repair (TEVAR) principles.
• Overview of adjunctive techniques for false lumen management (e.g., PETTICOAT, embolization).

Main Results:

• Preprocedural imaging identifies key features like intimal tear location and aortic involvement.
• TEVAR aims to exclude the primary tear, reduce false lumen perfusion, and promote remodeling.
• Adjunctive techniques address retrograde perfusion and optimize landing zones.

Conclusions:

• Familiarity with endovascular techniques and adjunctive strategies is essential for interpreting post-intervention imaging.
• Understanding expected imaging changes and potential complications aids patient management.
• This review details imaging modalities and provides examples of endovascular repairs for chronic aortic dissection.