Thoracic endoprostheses for type B aortic dissections

Abstract Endovascular treatment of acute complicated type B aortic dissection has become accepted as the first line of treatment. Advantages over open surgical repair include the minimal invasiveness of the procedure, the lack of a thoracotomy, no aortic cross-clamping causing end-organ ischaemia, and no requirement for full anticoagulation. Mortality and morbidity in terms of stroke and paraplegia are less than with open repair, although the long-term durability of endovascular repair is yet to be proven. We present a case of acute complicated type B aortic dissection treated with endovascular repair which resulted in the death of the patient. The reasons for this poor outcome are discussed, and the pitfalls and the ways to avoid them are identified.