Advances in Treatment and Prognosis for Acute Type A and Type B Aortic Dissections
A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".
Deadline for manuscript submissions: 25 March 2026 | Viewed by 1639
Special Issue Editor
Special Issue Information
Dear Colleagues,
Acute aortic dissection (AAD) often leads to false lumen expansion despite optimal medical treatment (OMT). This occurs in 20–30% of post-Type A and 20–50% of Type B cases, potentially necessitating future thoracoabdominal aortic replacement. Conversely, false lumen expansion does not occur in 70–80% of post-Type A and 50–80% of Type B cases, indicating that stent graft (SG) intervention, including frozen elephant trunk (FET), is unnecessary for these patients.
The challenge lies in identifying which patients will experience false lumen expansion. Various predictive factors, such as tear size, tear number, and initial vessel diameter, have been proposed. However, critical factors like the fragility of the adventitia and patient lifestyle are unmeasurable, making these predictions unreliable. Consequently, regular CT follow-up post-onset is the only way to determine whether false lumen expansion will occur.
Evaluating SG treatment outcomes in AAD requires addressing three critical points:
- Effectiveness: Can SG intervention prevent false lumen expansion?
- Appropriateness: Are unnecessary SG interventions avoided?
- Safety: Are complication rates acceptable?
Our studies (https://doi.org/10.1016/j.atssr.2023.05.014 and https://doi.org/10.1016/j.atssr.2024.09.002) were the first to establish a treatment strategy that identifies necessary SG interventions and demonstrated 10-year outcomes. These findings highlight the importance of balancing effective prevention with patient safety in AAD management.
Dr. Katsuhiko Oda
Guest Editor
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Keywords
- acute aortic dissection
- stent graft
- false lumen expansion
- thoracic endovascular aortic repair
- initial surgery for Type A acute aortic dissection
- frozen elephant trunk
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