Management of acute type B aortic dissection; ADSORB trial.

Published

Journal Article (Review)

OBJECTIVES: Type B dissection accounts for 25% to 40% of all aortic dissections. The current brief review presents an update on this disease, focusing on new data and insights that have come to light in the past 2 years since the topic was last reviewed at the 2012 AATS Aortic Symposium. METHODS: A literature search using PubMed (www.ncbi.nih.gov/pubmed) was performed with the search terms "acute type B aortic dissection" and "ADSORB trial," and all English-language articles published in print or available online between 2011 and March 2014 were carefully reviewed. Articles were selected for inclusion on the basis of perceived novel important insights into the pathophysiology and management of acute type B dissection. Data from the ADSORB (Acute Dissection: Stent graft OR Best medical therapy) trial were graciously provided by the ADSORB investigators prior to trial publication. RESULTS: Important new findings regarding acute type B aortic dissection include data on differences between blacks and whites with acute aortic dissection, proposed changes to the current classification system, anatomic predictors of late outcomes, long-term results with thoracic endovascular aortic repair, as well as additional insights into the uncommon but potentially deadly complication of retrograde type A dissection after endovascular repair. Further, early results from the ADSORB trial suggest a benefit for thoracic endovascular repair plus best medical therapy over medical therapy alone for aortic remodeling outcomes 1 year post dissection. CONCLUSIONS: A great deal of important information on acute type B aortic dissection has become available in the past 2 years since the 2012 AATS Aortic Symposium, some of which is summarized in this brief review. Further, it is clear that much additional investigation is needed so we in the aortic disease management community may continue to gain "new insights into an old disease."

Full Text

Cited Authors

  • Hughes, GC

Published Date

  • February 2015

Published In

Volume / Issue

  • 149 / 2 Suppl

Start / End Page

  • S158 - S162

PubMed ID

  • 25306065

Pubmed Central ID

  • 25306065

Electronic International Standard Serial Number (EISSN)

  • 1097-685X

Digital Object Identifier (DOI)

  • 10.1016/j.jtcvs.2014.08.083

Language

  • eng

Conference Location

  • United States