Endovascular versus medical therapy for uncomplicated type B aortic dissection: A qualitative review

Jonathan Merola, Karan Garg, Mark A. Adelman, Thomas S. Maldonado, Neal S. Cayne, Firas F. Mussa

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Uncomplicated type B dissections have been traditionally managed with antihypertensive therapy. In the endovascular era, this dictum has been revisited. This review pooled the available studies to compare the outcomes of best medical therapy (BMT) to thoracic endovascular aortic repair (TEVAR) for uncomplicated type B dissections. Methods: A literature search was performed to identify studies on uncomplicated type B dissections managed with BMT with and without TEVAR. The primary outcome measures were mortality rates at 30 days and at 2 years following intervention. Results: A total of 6 studies included 123 patients who underwent TEVAR/BMT, and 566 patients who had BMT alone. The mortality rates at 30 days (6.5% TEVAR/ BMT vs 4.8% BMT, P = .21) and at 2 years (9.7% vs 11.9%, P = .32) were similar. Renal failure was greater in TEVAR/BMT (15.4% vs 2.1%, P < .01). Rates of surgical reintervention/intervention were similar (17.6% vs 20.1%, P = .31). Conclusion: The TEVAR with BMT does not provide survival benefit compared to BMT alone, 2 years following uncomplicated type B aortic dissection.

Original languageEnglish (US)
Pages (from-to)497-501
Number of pages5
JournalVascular and Endovascular Surgery
Volume47
Issue number7
DOIs
Publication statusPublished - Oct 1 2013
Externally publishedYes

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Keywords

  • aortic dissection
  • endovascular repair
  • uncomplicated

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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