Commentary: Acute type B aortic dissection: Navigating new horizons

Abstract

Acute type B aortic dissection is a challenging acute aortic syndrome in which thoracic endovascular aortic repair (TEVAR) is indicated for such complications as rupture and malperfusion. 1,2 The role of TEVAR in this setting remains controversial when classic complications are absent. [1][2][3][4] The adverse natural history of uncomplicated acute type B dissection has recently prompted selective consideration of TEVAR to supplement best medical therapy. 3,4 The report by Hong and colleagues 5 in this issue of the Journal evaluates the rationale for TEVAR in uncomplicated type B aortic dissection. The authors highlight the advances in classification, emergence of high-risk features, and current management options and also suggest extended indications for TEVAR based on the presence of high-risk features. 5,6 How might their report stratify our management approach to type B aortic dissection? First, uncomplicated presentations are now defined by an absence of high-risk features, malperfusion, or rupture. [5][6][7] These patients require intense medical therapy, including titrated analgesia, strict blood pressure control, and close monitoring for disease progression. 5,6 This medical management can often be successful through the hyperacute (the first 24 hours of symptoms), acute (1-14 days from symptom onset), and subacute (15-90 days from symptom onset) phases of care. If a systolic blood pressure

Screening and Analysis of Aortic Dissection Based on Bioinformatics Methods Related Key Genes and Early Prevention and Treatment

“…There is growing evidence acknowledging the severity of the disease [7] . The risk of death from drug therapy alone remains high in treatment, and surgical treatment and endovascular repair can significantly reduce the incidence of the disease, but the improvement of longterm quality of life still needs to be improved [8][9][10] , so the intervention has to be further advanced, from early treatment to early diagnosis, over the years, doctor's diagnostic tools and management methods for the disease have continued to evolve, from the initial electrocardiogram, chest X-ray to echocardiography to computed tomography [11,12] , Although it effectively reduces the missed diagnosis rate, it cannot identify and accurately prevent the potential risk of AD in advance, and the risk of death with AD increases by 1 % to 3 % for each additional hour [13] . Therefore, a high degree of clinical suspicion is required for early diagnosis and targeted therapy to control disease progression in time and improve the chance of longterm survival.…”