TEVAR for chronic aortic dissection - is covering the primary entry tear enough?

Treatment-strategies for type B aortic dissection (TBAD) are rapidly developing towards endovascular treatment strategies. While TEVAR for acute TBAD shows favourable results, TEVAR in chronic TBAD following the same interventional strategies as in acute TBAD by covering the proximal entry-tear alone has shown unsatisfactory results with one third of the patients developing further false-lumen growth and mortality of 36% at 3 years. This review article describes endovascular strategies and adjunctive techniques to prevent distal false-lumen back-flow in patients with chronic TBAD, as covering the proximal entry tear has proven insufficient.