Expert Management of Type B Aortic Dissection From Onset With Thoracic Endovascular Aortic Repair

Annals of thoracic surgery short reports Pub Date : 2025-03-01 DOI:10.1016/j.atssr.2024.09.002

Katsuhiko Oda MD, PhD , Makoto Takahashi MD, PhD , Ryuichi Taketomi MD, PhD , Rina Akanuma MD , Takahiko Hasegawa MD , Satoshi Kawatsu MD, PhD

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Abstract

Background

Thoracic endovascular aortic repair is a key treatment of acute type B aortic dissection. We recognized the importance of managing type B aortic dissections from their onset and established our strategy in 2013. Here, we report the early and late outcomes of our comprehensive strategy for the management of type B aortic dissections.

Methods

This was a single-institution, observational, retrospective study. Between April 2013 and March 2024, 227 consecutive patients with acute type B aortic dissection were admitted to our institute and treated by our strategy. Early and late outcomes were also assessed for all patients.

Results

Thoracic endovascular aortic repair plus optimal medical treatment was performed to close the primary entry tear in 90 patients (40%) in the acute (12%), subacute (14%), and chronic (14%) phases. Optimal medical treatment alone was performed in 137 patients (60%). The early and late outcomes showed significant improvement.

Conclusions

Our strategy provided excellent early and late outcomes of acute type B aortic dissection, avoided postoperative paraplegia, and completely prevented thoracoabdominal aortic replacement.

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