Endovascular Repair in High-Risk Uncomplicated Type B Aortic Dissection: A Systematic Review and Single-Arm Meta-Analysis.

Thoracic endovascular aortic repair in hrTBAD patients is associated with low early mortality and favorable long-term survival and aortic remodeling, especially when performed during the subacute phase. Despite encouraging results, current evidence is limited to non-randomized studies. Further prospective trials are needed to refine patient selection and determine long-term efficacy.Clinical ImpactThis meta-analysis reinforces that thoracic endovascular aortic repair (TEVAR) for high-risk uncomplicated type B aortic dissection (hrTBAD) is safe and potentially beneficial, demonstrating low early mortality and encouraging aortic remodeling outcomes. However, the procedure is not devoid of complications, such as stroke, spinal cord ischemia, stent-induced new entry (SINE), or retrograde dissection, which may be infrequent in conservatively managed patients. Until randomized evidence becomes available, TEVAR should be considered on a case-by-case basis, integrating anatomical risk profiles, institutional expertise, and individualized prognostic assessment within multidisciplinary decision-making.