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May 1, 2014

Best surgical option for arch extension of type B dissection: the endovascular approach.

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Key result

Thoracic endovascular aortic repair with debranching has emerged as a viable alternative for managing type B aortic dissections involving the aortic arch, despite ongoing challenges with device conformability.

Population

Patients with acute type B aortic dissections, particularly those with entry tears near the left subclavian…

Comparison

Thoracic endovascular aortic repair, including… vs Conventional open surgical repair.

Design

Review

Authors

TKToru Kuratani

Discussion

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Overview

Supports TEVAR consideration for select arch-involved type B dissections; leaves open need for randomized comparative trials.

Structured PICO

P
Population
Patients with acute type B aortic dissections, particularly those with entry tears near the left subclavian artery requiring arch extension.
I
Intervention
Thoracic endovascular aortic repair (TEVAR), including hybrid surgery with debranching and fenestrated/branched TEVAR techniques.
C
Comparator
Conventional open surgical repair.

TEVAR, including hybrid and fenestrated/branched techniques, has evolved as a viable and less invasive alternative to conventional open surgery for type B aortic dissections involving the aortic arch.

Limitations

  • Lack of suitable ready-made devices specifically designed for aortic dissections
  • Risk of retrograde aortic dissection and stroke with hybrid arch repairs
  • Lack of long-term outcomes for fenestrated devices
  • Chimney graft technique is highly off-label and carries risk of endoleaks and stroke

Cite This Study

Toru Kuratani (2014) conducted a review in Type B aortic dissection. Thoracic endovascular aortic repair (TEVAR) with debranching was evaluated. Thoracic endovascular aortic repair with debranching has emerged as a viable alternative for managing type B aortic dissections involving the aortic arch, despite ongoing challenges with device conformability.

synapsesocial.com/papers/6a9e8755f835b2283e3800a6https://doi.org/10.3978/j.issn.2225-319x.2014.04.04
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Best surgical option for arch extension of type B aortic dissection: the open approach.2014 · 25 citations
  2. 2Early and late management of type B aortic dissection2014 · 47 citations
  3. 3Aortic arch surgery for type B aortic dissection: How far should we go? The value of a hybrid approach2023 · 3 citations
  4. 4Current management of acute type B dissection in 20212022
  5. 5What does anatomically eligible mean in contemporary thoracic endovascular aneurysm repair for type B aortic dissection?2025 · 1 citations