Uncomplicated type B aortic dissection: Challenges in diagnosis and categorization

Abstract

Background: Acute type B aortic dissection (TBAD) is a rare disease that is likely under-diagnosed in the UK. As a progressive, dynamic clinical entity, many patients initially diagnosed with uncomplicated TBAD deteriorate, developing end-organ malperfusion and aortic rupture (complicated TBAD). An evaluation of the binary approach to the diagnosis and categorisation of TBAD is needed. Methods: A narrative review of the risk factors predisposing patients to progression from unTBAD to coTBAD was undertaken. Results: Key high-risk features predispose the development of complicated TBAD, such as maximal aortic diameter > 40 mm and partial false lumen thrombosis. Conclusion: An appreciation of the factors that predispose to complicated TBAD would aid clinical decision-making surrounding TBAD.