Abstract
Type B aortic dissection is defined by an entry tear beyond the origin of the left subclavian artery. The acute phase is determined by the length of 2 weeks. The overall hospital mortality of this disease is in the 12–15 % range. In uncomplicated type B aortic dissections a primarily conservative approach with aggressive antihypertensive therapy is favored, which is supported by the INSTEAD trial. Aortic rupture and malperfusion (kidney, limbs, visceral organs, spinal cord) are the most important contributors to mortality and give the disease a “complicated” course. Risk factors such as aortic expansion, recurrent pain, refractory pain/hypertension, and periaortic hematoma are present in patients with a complicated course which increases hospital mortality to a 20 % rate. Interventional therapy (fenestration, stenting, stentgraft placement) as well as surgical therapy in combination with optimal medical therapy are options for patients with complicated type B aortic dissections.
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Schachner, T., Grimm, M. (2014). Complicated and Uncomplicated Acute Type B Aortic Dissection: Definitions and Approach in the Light of IRAD and INSTEAD. In: Bonser, R., Pagano, D., Haverich, A., Mascaro, J. (eds) Controversies in Aortic Dissection and Aneurysmal Disease. Springer, London. https://doi.org/10.1007/978-1-4471-5622-2_29
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DOI: https://doi.org/10.1007/978-1-4471-5622-2_29
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