Thoracic endovascular aortic repair (TEVAR) has evolved into an established treatment option for type B aortic dissection (TBAD) since it was first introduced 2 decades ago. Morbidity and mortality have decreased due to the minimally invasive character of TEVAR, with adequate stabilization of the dissection, restoration of true lumen perfusion, and subsequent positive aortic remodeling. However, several studies have reported severe setbacks of this technique. Indeed, little is known about the biomechanical behavior of implanted thoracic stent-grafts and the impact on the vascular system. This study sought to systematically review the performance and behavior of implanted thoracic stent-grafts and related biomechanical aortic changes in TBAD patients in order to update current knowledge and future perspectives.
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Need for and update on clinical trials for uncomplicated type B aortic dissection.
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Academic Department of Vascular Surgery, South Bank Section, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, British Heart Foundation Centre of Research Excellence, St Thomas' Hospital, London, UK.
The mainstay of management for uncomplicated type B aortic dissection is currently optimal medical therapy, targeting blood pressure and heart rate, along with serial imaging. There is a paucity of data that informs whether early intervention with thoracic endografting in this group of patients will promote aortic remodeling and better long-term outcomes. Investigations to date, including the Investigation of Stent Grafts in Aortic Dissection (INSTEAD), INSTEAD-XL, and Acute Dissection: Stent Graft or Best Medical Therapy (ADSORB) studies, have compared thoracic endovascular aortic repair (TEVAR) with optimal medical therapy in patients with uncomplicated type B aortic dissection but have not shown a benefit for TEVAR conclusively.
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Department of Interventional Radiology, Semmelweis University, Budapest, Hungary; Semmelweis Aortic Center, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. Electronic address:
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Department of Surgery, Division of Vascular & Endovascular Surgery, UC San Diego, La Jolla, CA; Center for Learning and Excellence in Vascular and Endovascular Research, UC San Diego, La Jolla, CA. Electronic address:
Objective: There is a paucity of data on sex-based differences in outcomes after thoracic endovascular aortic repair (TEVAR) performed for Stanford type B aortic dissections (TBAD). Examining the predictive role of sex could shape future clinical guidelines for TEVAR. Thus, this study aims to evaluate the association between sex and postoperative outcomes after TEVAR performed for TBAD.
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The complex anatomy of the bronchial arteries: a meta-analysis with potential implications for thoracic surgery and hemoptysis treatment.
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The present meta-analysis aimed to provide the most detailed and comprehensive anatomical description of bronchial arteries (BAs) using data available in the literature. Adequate knowledge of the normal anatomy and morphological variations of BAs can be clinically significant; for example, this approach can prevent potential risks while undertaking bronchial artery embolization (BAE) procedures and, ultimately, lead to better patient outcomes. Major medical databases such as PubMed, Scopus, Embase, Web of Science, Google Scholar, and the Cochrane Library were searched.
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