title: Endovascular versus medical therapy for uncomplicated type B aortic dissection: a qualitative review.
abstract: BACKGROUND
  Uncomplicated type B dissections have been traditionally managed with antihypertensive therapy. In the endovascular era, this dictum has been revisited. This review pooled the available studies to compare the outcomes of best medical therapy (BMT) to thoracic endovascular aortic repair (TEVAR) for uncomplicated type B dissections.
  
  
  METHODS
  A literature search was performed to identify studies on uncomplicated type B dissections managed with BMT with and without TEVAR. The primary outcome measures were mortality rates at 30 days and at 2 years following intervention.
  
  
  RESULTS
  A total of 6 studies included 123 patients who underwent TEVAR/BMT, and 566 patients who had BMT alone. The mortality rates at 30 days (6.5% TEVAR/BMT vs 4.8% BMT, P = .21) and at 2 years (9.7% vs 11.9%, P = .32) were similar. Renal failure was greater in TEVAR/BMT (15.4% vs 2.1%, P < .01). Rates of surgical reintervention/intervention were similar (17.6% vs 20.1%, P = .31).
  
  
  CONCLUSIONS
  The TEVAR with BMT does not provide survival benefit compared to BMT alone, 2 years following uncomplicated type B aortic dissection.
authors.affiliation: 1Division of Vascular and Endovascular Surgery, New York University School of Medicine, New York, NY, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Merola
authors.forename: Karan
authors.initials: K
authors.lastname: Garg
authors.forename: Mark A
authors.initials: MA
authors.lastname: Adelman
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Maldonado
authors.forename: Neal S
authors.initials: NS
authors.lastname: Cayne
authors.forename: Firas F
authors.initials: FF
authors.lastname: Mussa
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D001019:Aortic Rupture / Q000209:etiology; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D051437:Renal Insufficiency / Q000209:etiology; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: aortic dissection; endovascular repair; uncomplicated