Stent graft management of stable, uncomplicated type B aortic dissection.
Aortic dissection has an incidence of 2.6 to 3.5 per 100,000 person years. Although the traditional approach has focused on surgical and medical intervention, several studies demonstrate the efficacy of endovascular repair for aortic dissection. Bolstered by a high technical success rate and improved morbidity and mortality relative to its surgical counterpart, endovascular repair has become a first-line treatment for complicated type B aortic dissection. The debate over the optimal approach to uncomplicated type B dissection is more contentious. The consensus remains in support of medical therapy tailored for tight control of hypertension. The poor long-term results of this regimen, with up to 50% mortality at 5 years, have shifted attention to endovascular stent grafting as an alternative. This article reviews the latest research on uncomplicated type B dissection and its treatment, concentrating on endovascular technique, anatomic considerations, timing of intervention, and outcomes. Early research indicates endovascular stent grafting is a promising modality for these patients.
Kahn
Sidney L
SL
University of Virginia Health System, Charlottesville, Virginia 22908, USA.
Dake
Michael D
MD
D000784:Aortic Dissection / Q000150:complications / Q000628:therapy*; D001014:Aortic Aneurysm / Q000150:complications / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D006801:Humans; D015607:Stents