Outcome of Endovascular Treatment of Acute Type B Aortic Dissection

Complicated type B aortic dissection is a life-threatening condition. For the last decade, endovascular stent-graft placement has been increasingly used to treat this condition. We undertook a summary analysis of published studies reporting the outcome of stent-grafts to treat complicated type B dissection. Studies were identified from a literature search using the MEDLINE database, and included studies when 10 or more patients were reported and at least in-hospital mortality was presented. A total of 942 patients were included from 29 studies. All patients were reported to have complications requiring intervention ( hypotension in 17%). In-hospital mortality was 9% and other major complications (ie, stroke, paraplegia, conversion to type A dissection, bowel infarction, major amputation) occurred in 8.1%. Long-term follow-up was limited to a mean of 20 months. During this time, reintervention was required in 10.4% and aortic rupture was reported in 0.8%. Endovascular treatment of complicated acute type B aortic dissection seems to provide favorable initial outcomes and would seem to be a great addition to the treatment options for this condition. Further study of long-term outcomes is required. (Ann Thorac Surg 2008; 86: 1707-12) (C) 2008 by The Society of Thoracic Surgeons