Retrograde Typ-A-Aortendissektion nach TEVAR: Inzidenz, Risikofaktoren und klinisches Ergebnis

Endovascular aortic arch repair using a double-branched approach

The last 15 years have overwhelmed the surgical community with a range of approaches in treating pathologies involving the aortic arch of which some are here to stay. The ones to stay are-in the authors' opinion-refined classical surgical approaches such as the frozen elephant trunk technique, near-orthotopic combined vascular and endovascular approaches such as subclavian to carotid transposition/bypass and double transposition, and finally, near-orthotopic advanced endovascular solutions such as the double-endovascular repair using fenestrated and/or branched solutions which will be the main focus of this article.

Thoracic endovascular aortic repair for uncomplicated type B aortic dissection

PURPOSE OF REVIEW

Type B aortic dissection has largely been regarded as the nice dissection with regard to its natural course, especially when compared with type A aortic dissection. However, a more thorough look into the natural course of the disease has shown that a high number of patients with type B aortic dissection will experience complications and will require therapy, sooner or later.

RECENT FINDINGS

Reasons and timepoints are different, being malperfusion, contained rupture and retrograde propagation of the disease into the aortic arch or into the ascending aorta in the early phase and being mainly aneurysmal formation in the chronic phase of the disease.

SUMMARY

This article provides the interested reader with detailed knowledge regarding the natural course of the disease and is meant as a companion to anticipate the right timepoint for therapy and finally as a guide to do the right things when advancing to treatment.