Favorable Impact of Thoracic Endovascular Aortic Repair on Survival of Patients With Acute Uncomplicated Type B Aortic Dissection

The authors compared the early and long-term survival in 9165 patients undergoing medical therapy (95%), open repair (2%), and thoracic endovascular aortic repair (TEVAR, 2.9%) for uncomplicated acute type B dissection. One- and 5-year survivals were 84% and 60% for medical therapy, 76% and 67% for open repair, and 85% and 76% for TEVAR (log-rank, P < .01). On risk-adjusted multivariable analysis, TEVAR had a significant survival benefit compared to medical therapy (hazard ratio, 0.68; 95% confidence interval, 0.6-0.8; P < .01).  This study on survival after acute uncomplicated type B aortic dissection shows a survival advantage for TEVAR over medical therapy. These data add further evidence for a paradigm shift in the management of acute type B dissection in favor of early TEVAR.