Table 2 Interventions for type B aortic dissection by indication and timing.
| Disease stage (from onset) | Hyperacute phase (≤48 hr) | Acute phase (≤14 D) | Subacute phase (≤3 M) | Early chronic phase (<12 M) | Chronic phase (≥1 yr) | |||
|---|---|---|---|---|---|---|---|---|
| Indication | Malperfusion and rupture (impending rupture) | Refractory hypertension, recurrent and persistent thoracodorsal pain, and large aortic diameter (≥40 mm) | Hemorrhagic pleural effusion, malperfusion on imaging, re-hospitalization, entry on the lesser curvature side, false lumen diameter >22 mm | False lumen dilatation and aneurysm formation | ||||
| Definition before 2000 | Complicated | Uncomplicated | ||||||
| IRAD definition (broad sense) | Complicated | Uncomplicated | ||||||
| SVS/STS reporting standard | Complicated | (Uncomplicated) high-risk feature | N/A | |||||
| Invasive treatment | 1st: TEVAR (if TEVAR is not possible, then fenestration is permitted for malperfusion) | TEVAR | 1st: graft replacement | |||||
| If endovascular treatment is not possible or ineffective, open surgery (graft replacement or fenestration) | If graft replacement is not possible or high risk, then TEVAR | |||||||
IRAD: International Registry of Acute Aortic Dissection; SVS: Society for Vascular Surgery; STS: Society of Thoracic Surgeons; N/A: not applicable; TEVAR: thoracic endovascular aortic repair