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New paradigms in the management of acute type B aortic dissection

Parisi, Rosario; Secco, Gioel Gabrio; Fattori, Rossella

doi: 10.1097/HCO.0000000000000215
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Purpose of review Type B aortic dissection is a relatively uncommon and multifaceted disease, whose management is ongoing debated. Its wide range of clinical presentations and anatomical features hamper the early identification and medical management. In the past few years, the introduction of endovascular techniques opened new paradigms in comprehension and management of aortic diseases. Aim of this review is to discuss contemporary therapeutic approaches of acute type B aortic dissections highlighting the growing role of thoracic endovascular aortic repair (TEVAR) in focusing its complex physiopathology.

Recent findings Prompt medical therapy followed by endovascular repair should be considered as the gold standard in complicated acute type B aortic dissection. Moreover, recent findings also suggest a potential benefit in case of uncomplicated cases.

Summary Management of acute type B aortic dissection is progressively shifting into endovascular approach. However, further studies are warranted to define the optimal treatment strategy in each subset of patients and anatomical features.

Cardiology and Interventional Cardiology Unit, Ospedali Riuniti Marche Nord, Pesaro, Italy

Correspondence to Rossella Fattori, MD, Cardiology and Interventional Cardiology Unit, Ospedali Riuniti Marche Nord Piazzale Cinelli 1, Pesaro 61121, Italy. Tel: +390721362244; fax: +390721362292; e-mail:

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