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Role of Endoluminal Techniques in the Management of Acute Type B Aortic Dissection and Intramural Haematoma

CardioVascular and Interventional Radiology volume 43, pages 1798–1807 (2020)Cite this article

Abstract

Twenty-five years ago, optimal medical management was the mainstay of treatment in acute type B aortic dissection (TBAD) and intramural haematoma (IMH), with surgery being reserved for cases with rupture or critical branch vessel ischaemia. Less invasive endoluminal management of TBAD and IMH has developed rapidly over the past two and a half decades, thus changing the treatment algorithm in these patients. Today the focus has shifted to primary management with a combination of endoluminal intervention and optimal medical treatment. The purpose of this article is to describe the various interventional techniques, discuss the indications for intervention, and present the results in the current literature regarding clinical (rupture, branch vessel ischaemia) as well as morphological response (aortic remodelling), complications, and morbidity/mortality associated with endoluminal intervention.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Christliches Krankenhaus Quakenbrück, Danziger Strasse 2, 49610, Quakenbrück, Germany

    Ajay Chavan

  2. Institute of Diagnostic and Interventional Radiology, Klinikum Oldenburg, Oldenburg, Germany

    Osama Eldergash

  3. Clinic for Diagnostic and Interventional Radiology, UKGM Marburg, Marburg, Germany

    Rohit Philip Thomas

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  1. Ajay Chavan
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  2. Osama Eldergash
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  3. Rohit Philip Thomas
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Correspondence to Ajay Chavan.

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Chavan, A., Eldergash, O. & Thomas, R.P. Role of Endoluminal Techniques in the Management of Acute Type B Aortic Dissection and Intramural Haematoma. Cardiovasc Intervent Radiol 43, 1798–1807 (2020). https://doi.org/10.1007/s00270-020-02652-w

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  • DOI: https://doi.org/10.1007/s00270-020-02652-w

Keywords

  • TEVAR
  • Stent-graft
  • Balloon fenestration
  • True lumen stenting
  • TBAD
  • IMH