Thoracic endovascular aortic repair for uncomplicated Type B aortic dissection: What is the optimal time window for intervention?

Authors: Al-Tawil M; Chikhal R; Abdelhaliem A; 
Source: Journal of cardiac surgery [J Card Surg] 2022 Apr; Vol. 37 (4), pp. 1002-1003. Date of Electronic Publication: 2021 Dec 27.
Abstract: Uncomplicated Type B aortic dissection (un-TBAD) is still managed conservatively with optimal medical therapy (OMT) despite evidence in favour of thoracic endovascular aortic repair (TEVAR) for un-TBAD. OMT aims to regulate heart rate and blood pressure and patients require long-term follow-up to evaluate the extent of dissection, however, many un-TBAD patients are lost to follow-up. Several trials and observational studies evaluated the use of TEVAR in combination with OMT in un-TBAD and proved the safety, effectiveness, and comparability of TEVAR relative to OMT alone. What remains in question is the optimal time window to intervene with TEVAR. This was recently addressed in a fascinating review by Jubouri et al. AIMS: This commentary aims to discuss the recent review by Jubouri et al. which further proved that TEVAR is safe and effective in un-TABD and investigated the optimal timing of TEVAR in un-TBAD.

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