title: Uncomplicated type B dissection: are there any indications for early intervention?
abstract: Currently thoracic endovascular repair (TEVAR) has a limited role in uncomplicated type B aortic dissection. Aggressive medical therapy is deemed appropriate for most of these patients allowing one-year survival rate of 80-90%. Outcomes are less than optimal in the long term, however, since aorta related complications (disease progression, rapid deterioration, acute rupture and elevated mortality) may occur in up to 50% of patients at five years. Subgroups of patients with uncomplicated type B dissection may benefit from early stent-graft placement, but identification of these remains difficult. Only future studies, especially randomized trials, will clarify the utility of early TEVAR in the setting of uncomplicated acute type B dissection.
authors.affiliation: Vascular Endovascular Surgery, Hospital S. M. Misericordia, University of Perugia, Perugia, Italy.
authors.forename: P
authors.initials: P
authors.lastname: De Rango
authors.forename: A
authors.initials: A
authors.lastname: Estrera
mesh_terms: D000784:Aortic Dissection / Q000266:history / Q000628:therapy*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000266:history / Q000628:therapy*; D002317:Cardiovascular Agents / Q000266:history / Q000627:therapeutic use*; D057510:Endovascular Procedures / Q000266:history; D019317:Evidence-Based Medicine; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000266:history
chemical_list: D002317:Cardiovascular Agents