title: Endovascular stent-graft placement for complications of acute type B aortic dissection.
abstract: OBJECTIVE
  To review the concepts and current clinical results of endovascular stent-graft placement for acute complicated type B aortic dissection.
  
  
  RESULTS
  The optimal treatment for patients with dissections confined to the descending aorta (Stanford type B-AD) remains a matter of debate. Usually, antihypertensive medical therapy with strict blood pressure lowering below 135/80 mm Hg represents the first choice for patients with uncomplicated type B-AD. Patients with acute complicated type B-AD remain a major therapeutic challenge because surgery of the descending aorta is still associated with high morbidity and mortality. In 1999, endovascular stent-graft placement was introduced as a novel, less invasive treatment option for patients with type B aortic dissection. Current indications include acute (contained) aortic rupture, symptomatic ischemic branch vessel involvement, early aortic expansion, or unrelenting pain. So far, few studies on stent-graft placement in patients with acute complicated aortic dissection have been published reporting an early mortality between 0 and approximately 20%.
  
  
  CONCLUSIONS
  To date, there is limited experience with endovascular stent-graft placement for acute complicated type B aortic dissection demonstrating its feasibility and life-saving potential. The endovascular approach can avoid the major trauma of open surgery and should help to get patients out of the acute life-threatening phase of the disease; however, long-term results are needed to assess the durability of this treatment.
authors.affiliation: Department of Cardiology, West-German Heart Center Essen, University of Duisburg-Essen, Essen, Germany. holger.eggebrecht@uni-essen.de
authors.forename: Holger
authors.initials: H
authors.lastname: Eggebrecht
authors.forename: Lars
authors.initials: L
authors.lastname: Lönn
authors.forename: Ulf
authors.initials: U
authors.lastname: Herold
authors.forename: Frank
authors.initials: F
authors.lastname: Breuckmann
authors.forename: Rainer
authors.initials: R
authors.lastname: Leyh
authors.forename: Heinz G
authors.initials: HG
authors.lastname: Jakob
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D000792:Angiography; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D006801:Humans; D008875:Middle Aged; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome