[Complicated acute type B aortic dissection-what does endovascular therapy contribute?].

BACKGROUND

Acute aortic dissection type B is a severe and life-threatening vascular emergency. Complications such as rupture and/or malperfusion of organs are the main reasons for early mortality.

OBJECTIVES

The aim is to provide an overview on important diagnostic radiological findings, conservative as well as endovascular therapeutic options for patients presenting with rupture or malperfusion syndromes.

RESULTS

Medical treatment consisting of blood pressure and heart rate control as well las adequate analgesia remains the cornerstone therapy of all type B aortic dissections. In case of organ malperfusion, various endovascular therapies, e. g., endoluminal fenestration of dissection flap, thoracic stent-graft implantation (TEVAR) or branch vessel stenting, are available. In the case of aortic rupture, TEVAR has become the standard owing to its lower mortality compared to open surgical repair.

DISCUSSION: For the treatment of complicated type B aortic dissection, a number of endovascular options are available. For optimal treatment, profound knowledge of the disease, of the diagnostic workup, and of the interventional procedures is mandatory.