Chronic Thoracic Aortic Dissection: How to Treat, When to Intervene

Abstract

Thoracic aortic dissection (AD) is associated with increased morbidity and mortality. Acute aortic syndrome is the first presentation of the disease in most cases. While acute AD management follows concrete guidelines because of its urgent and life-threatening nature, chronic AD is usually overlooked, although it concerns a wide spectrum of patients surviving an acute event. Acute AD survivors ultimately enter a chronic aortic disease course. Patients with chronic thoracic AD (CTAD) require lifelong surveillance and a proportion of them may present with symptoms and late complications demanding further surgical or endovascular treatment. However, the available data concerning the management of CTAD is sparse in the literature. The management of patients with CTAD is challenging as far as determining the best medical therapy and deciding on intervention are concerned. Until recently, there were no guidelines or recommendations for imaging surveillance in patients with chronic AD. The diagnostic methods for imaging aortic diseases have been improved, while the data on new endovascular and surgical approaches has increased significantly. In this review, we summarize the current evidence in the diagnosis and management of CTAD and the latest recommendations for the surgical/endovascular aortic repair of CTAD.

Treatment of Uncomplicated Type B Aortic Dissection: Optimal Medical Therapy vs TEVAR + Optimal Medical Therapy

“…In summary, while the pharmacological management of uTBAD is currently suggested by expert opinion, the level of evidence is weak. 17…”

“…The patients who have TEVAR should have close surveillance with follow up imaging after TEVAR repair at 1 months, 6 months, and annually thereafter is recommended. 17…”

The recognition of severe thoracic aortic dissection using conventional chest radiography in conjunction with a whale optimized bilateral residual convolutional neural network

“…The data on novel endovascular and surgical techniques has grown dramatically, while the diagnostic techniques for imaging aortic illnesses have improved. Describe the most recent recommendations for the surgical/endovascular aortic repair of CTAD in this paper [10] as well as the most recent research findings in the diagnosis and management of CTAD. Patients with type B aortic dissection (TBAD) frequently appear in an emergency situation.…”

Optimising anesthesia support during operations on the abdominal aorta and its branches

“…Innominate artery compression syndrome happens when the brachiocephalic trunk (innominate artery) is positioned anterior to the trachea and further to the left than usual, compressing the artery. Up to 45% to 65% of patients undergoing vascular ring repair have a double aortic arch (DAA) [30]. There are numerous subtypes, but all of them frequently cause compression because the ascending aorta divides into two vessels that pass on either side of the esophagus and trachea.…”