Type B Aortic Dissection
Traditionally, type B dissections (Dissections beyond the left subclavian artery) are treated conservatively unless one of the following situations is present.
● Aneurysm of pseudolumen. ● Tear or leak of the psudolumen. ● Visceral branch or limb branch involvement causing decrease in perfusion of an organ.
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However, persisting pain not responding to conservative treatment is a relative indication for intervention nowadays. Various methods of interventional procedures are attempted to control the primary tear in the intima.
One common interventional method is to stent across the proximal intimal tear. This prevents the blood from entering the pseudo-lumen and eventually blood in the pseudo-lumen gets thrombosed.
Whenever decision is made to treat the type B Dissection conservatively, a close follow up is mandatory. CT Aortogram/MR Aortogram should be performed at 3 months and one year.
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