Uncomplicated Type B Aortic Dissection: Challenges in Diagnosis and Categorization

Ann Vasc Surg. 2023 Aug:94:92-101. doi: 10.1016/j.avsg.2023.04.006. Epub 2023 Apr 17.

Abstract

Background: Acute type B aortic dissection (TBAD) is a rare disease that is likely under-diagnosed in the UK. As a progressive, dynamic clinical entity, many patients initially diagnosed with uncomplicated TBAD deteriorate, developing end-organ malperfusion and aortic rupture (complicated TBAD). An evaluation of the binary approach to the diagnosis and categorisation of TBAD is needed.

Methods: A narrative review of the risk factors predisposing patients to progression from unTBAD to coTBAD was undertaken.

Results: Key high-risk features predispose the development of complicated TBAD, such as maximal aortic diameter > 40 mm and partial false lumen thrombosis.

Conclusion: An appreciation of the factors that predispose to complicated TBAD would aid clinical decision-making surrounding TBAD.

Publication types

  • Review

MeSH terms

  • Aortic Aneurysm, Thoracic* / surgery
  • Aortic Dissection* / diagnostic imaging
  • Aortic Dissection* / surgery
  • Aortic Rupture* / diagnostic imaging
  • Aortic Rupture* / etiology
  • Aortic Rupture* / surgery
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Endovascular Procedures* / adverse effects
  • Humans
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome