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Semin intervent Radiol 2024; 41(06): 588-594
DOI: 10.1055/s-0044-1800849
Review Article

Controversies in Chronic Aortic Dissection

Yanqing Zhao
1   Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health, Ann Arbor, Michigan
2   Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, China
,
Shinichi Fukuhara
3   Department of Cardiac Surgery, University of Michigan Health, Ann Arbor, Michigan
,
Minhaj S. Khaja
1   Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health, Ann Arbor, Michigan
3   Department of Cardiac Surgery, University of Michigan Health, Ann Arbor, Michigan
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Abstract

Chronic type B aortic dissection (cTBAD) often requires intervention due to complications like aortic aneurysmal dilatation and rupture, traditionally managed via open surgery. With the continued rise of endovascular therapies, thoracic endovascular aortic repair (TEVAR) is increasingly used, although its role in cTBAD is debated due to challenges such as a thick dissection septum, poor landing zones, and persistent false lumen flow. However, mounting evidence demonstrates TEVAR is a viable option for cTBAD, particularly for patients with high risks treated with open surgery. Advances in endovascular techniques, such as false lumen obliteration techniques and landing zone optimization strategies, have enhanced its technical success rate and clinical outcomes. However, continued research is needed to validate these methods and confirm their long-term benefits. In this review article, we not only update the emerging endovascular armamentarium but also discuss the technical considerations in catheter-based treatment approaches and respective outcomes.

Keywords

chronic aortic dissection - false lumen embolization - chronic type B aortic dissection - TEVAR - false lumen degeneration


Publikationsverlauf

Artikel online veröffentlicht:
11. Dezember 2024

© 2024. Thieme. All rights reserved.

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