Management of acute type B aortic dissections is guided by clinical and imaging information, but prognostic factors remain unclear and thus optimal therapeutic management of patients is controversial (1,2). Usually, stable patients are managed with medical treatment, despite pretty poor long-term outcomes with a 30% cumulative mortality at 5 years (3,4) owing to aneurysm expansion, whereas those with complicated clinical presentation (peripheral vascular ischemia or hemodynamic instability) undergo surgery of the descending aorta, which is associated with a high morbidity and mortality (5,6,7). Recently, endovascular...

1. Population: Between January 1994 and January 2013, a total of 126 patients were admitted to our institution during the acute phase (within 14 days of onset) of a type B aortic dissection. Out of these 126 patients, 65 were excluded (47 had not initial CT images available,15 had no follow-up CT imaging in our center and 3 underwent prior aortic surgery), resulting in a 61 patients cohort with acute type B aortic dissections analyzed into this retrospective study. (figure 1) 2. CT analysis and...

1. Basic and clinical characteristics and outcome We identified 61 patients who underwent at least one CT at admission and one at follow-up. A total of 487 CT were reviewed. Mean follow-up was 4.5 years. Patients’ basic and clinical characteristics are shown in Table 1. The mean age was 60±12 years. The majority of patients (70,5%) were male. 32 patients (52%) developed a complication of their dissection, immediately or up to 10 years after, including 9 dissection-related deaths and 23 patients who underwent surgical intervention;...

In our retrospective study on 61 patients with acute type B aortic dissection, we identified aortic maximal diameter and progression of false lumen thrombosis as predictors of complications (aortic event requiring surgery or death). These patientsmight benefit from a more strict surveillance or an early prophylactic intervention, deemed possible owing to a lesser risk thanks to EVAR.

(1) Ehrlich MP, Dumfarth J, Schoder M and al. Midterm results after endovascular treatment of acute, complicated type B aortic dissection. Ann Thorac Surg 2010 ; 90 : 1444-8 (2) Kato M, Bai H, Sato K and al. Determining surgical indications for acute type B dissections based on enlargement of aortic diameter during the chronic phase. Circulation 1995 ; 92 : II107-122) (3)Sakakura K, Kubo N, Ako J, Ikeda N, Funayama H, Hirahara T, Sugawara Y, Yasu T, Kawakami M, Momomura S. Determinants of in-hospital...