Update on Outcomes of Acute Type B Aortic Dissection

Editor's Choice – Management of Descending Thoracic Aorta Diseases

“…Aortic rupture is associated with a high mortality, irrespective of the type of treatment, 52,70e73 whereas patients with impending rupture who have no haemodynamic complications have better outcomes. 56,70 Renal and/or visceral ischaemia may be difficult to detect. Renal ischaemia can increase creatinine levels and potentially induce refractory hypertension.Treatment of renal ischaemia is important to prevent permanent renal insufficiency and refractory hypertension which is likely to result in a more rapid expansion of the affected aorta.…”

Endovascular Repair of Thoracic Aortic Emergencies

“…They concluded that mortality associated with complicated dissection was 17%. In contrast, 53% of patients with uncomplicated dissection were managed medically, with a mortality rate of only 1.2% (Estrera et al, 2007). TEVAR should now be considered the gold standard for complicated acute type B thoracic dissections and symptomatic penetrating ulcers.…”

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“…Indications for surgery include refractory pain, progression of dissection, and acute lower extremity ischemia. 4,6,9,12 Contemporary endovascular treatment lets the surgeon occlude the entry site using the stent grafts. 5,9,10 When choosing endovascular treatment of type B aortic dissection, implantation criteria must be fulfilled, determining treatment success.…”

“…4,5 The mortality rate in distal aortic dissections is approximately 10%. [6][7][8] If the aortic dissection is complicated, with acute visceral or limb ischemia, or aortic rupture, surgery is essential and indicated. 2,4,5 Mortality in the presence of these complications rises to 30%.…”