Uncomplicated Type B Aortic Dissection: Must Medical Treatment Still Be The Best Option? Yes, Conservative Treatment Is The Best Option

Acute type-B dissection is one of the most dreaded diseases that can occur in the aorta. Classically, the preferred medical treatment has been the perfect control of the blood pressure and the pain. However, the advent of endovascular therapy and its successful implementation in complicated aortic dissections (patients with hemodynamic instability, peripheral ischemia, visceral malperfusion or contained rupture) has expanded its use in all cases. This has led to considerable controversy regarding the appropriate treatment of this disease, especially in uncomplicated aortic dissections. To date, endovascular therapy appears to cause more thrombosis of the false lumen and a more favorable remodeling of the aorta during the follow-up, but missing data shows that this approach improves the overall survival of these patients. The authors of these articles analyze the effectiveness of endovascular therapy in uncomplicated dissections of the descending aorta, reviewing the latest evidence for and against its use. (C) 2014 SEACV. Published by Elsevier Espana, S.L.U. All rights reserved.