What is the best thoracic endovascular aortic repair landing zone for Type B aortic dissection?

Dissection morphology is important when considering landing zones for thoracic endovascular aortic repair. Landing proximally in a healthy aorta, free of dissection and intramural hematoma, is generally recommended. For the most common location of the proximal entry tear near the left subclavian artery, this generally requires landing in zone 2. However, zone 2 landing is associated with higher rates of stroke and need for left subclavian revascularization. Distal landing zone 5 is associated with much higher rates of spinal cord ischemia, without significant benefit over zone 4 or bare metal stent extension so should be avoided, especially for treatment of uncomplicated dissections.