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Should endovascular therapy be recommended for descending thoracic aortic dissections?

A Arafat, J Idrees & EE Roselli

Descending aortic dissection is a lifelong disease with a high morbidity and mortality. Current management is based on presentation. In the acute setting, the initial approach is medical therapy to reduce the aortic impulse (D pressure/D time) with intravenous antihypertensive medications. Intervention is recommended when complications, such as rupture and end-organ malperfusion, are present. In the chronic state, dissections are managed medically with close imaging surveillance until complications, such as aneurysmal degeneration, warrant surgical intervention.