Management algorithm for acute type B aortic dissection
Management algorithm for acute type B aortic dissection Acute Aortic Syndromes Acute Aortic Syndromes
«Flowchart»
Initial diagnosis of
type B dissection
Initial diagnosis of
type B dissection
Initial diagnosis of
type B dissection

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Favorable thoracic
endovascular aortic repair
(TEVAR) anatomy?
Favorable thoracic
endovascular aortic repair
(TEVAR) anatomy?
Favorable thoracic
endovascular aortic repair
(TEVAR) anatomy?


High-risk features
upon initial computed
tomography?
High-risk features
upon initial computed
tomography?
High-risk features
upon initial computed
tomography?


Complicated
Complicated
Complicated Complicated
Uncomplicated
Uncomplicated
Uncomplicated Uncomplicated
TEVAR/
adjunctive
procedures
TEVAR/
adjunctive
procedures
TEVAR/
adjunctive
procedures


Open surgical
reconstruction/
adjunctive
procedures
Open surgical
reconstruction/
adjunctive
procedures
Open surgical
reconstruction/
adjunctive
procedures



Yes
Yes
Yes
No
No
No
Favorable TEVAR
anatomy with high
risk features + life
expectancy >5 years?
Favorable TEVAR
anatomy with high
risk features + life
expectancy >5 years?
Favorable TEVAR
anatomy with high
risk features + life
expectancy >5 years?



Continue optimal
medical therapy
(OMT) with
surveillance
Continue optimal
medical therapy
(OMT) with
surveillance
Continue optimal
medical therapy
(OMT) with
surveillance



Yes
Yes
Yes
No
No
No
Continue OMT
with more
frequent
surveillance
Continue OMT
with more
frequent
surveillance
Continue OMT
with more
frequent
surveillance



Consider
TEVAR
Consider
TEVAR
Consider
TEVAR

Yes
Yes
Yes
No
No
No