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\begin{document}

\title{Criteria for Endovascular Intervention in Type B Aortic Dissection}



\author[1]{Sven Zhen Cian Tan}%
\author[1]{Sidhant Singh}%
\author[1]{Joaquin Alfonso Palanca}%
\author[1]{Natasha Austin J}%
\author[2]{Matti Jubouri}%
\author[3]{Damian  Bailey}%
\author[4]{Ian Williams}%
\author[5]{Christoph Nienaber}%
\author[6]{Joseph Coselli}%
\author[7]{Mohamad Bashir}%
\affil[1]{Queen Mary University of London Barts and The London School of Medicine and Dentistry}%
\affil[2]{Hull York Medical School}%
\affil[3]{University of South Wales Faculty of Life Sciences and Education}%
\affil[4]{University Hospital of Wales}%
\affil[5]{Royal Brompton and Harefield Hospitals}%
\affil[6]{Baylor College of Medicine Michael E DeBakey Department of Surgery}%
\affil[7]{NHS Wales Health Education and Improvement Wales}%


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  \date{May 18, 2024}


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\begin{abstract}
\textbf{Background} The use of thoracic endovascular aortic repair
(TEVAR) for the management of uncomplicated type B aortic dissection
(un-TBAD) remains controversial. There is a lack of consensus over
whether pre-emptive TEVAR should be carried out in patients with un-TBAD
at risk of progression to complicated TBAD. We present a review of
current evidence and seek to suggest criteria where endovascular
intervention in un-TBAD may prove beneficial relative to pharmacotherapy
alone. \textbf{Methods and Materials} PubMed and Cochrane databases were
searched using terms including: type B aortic dissection, risk factors,
medical therapy, TEVAR, false lumen expansion, and mortality. Papers
were selected based on title and abstract. \textbf{Results} Optimal
medical therapy remains the mainstay treatment for patients with
un-TBAD, however patients with un-TBAD present with varying degrees of
disease progression risk. Factors such as age, aortic morphology,
history of connective tissue disorders, false lumen thrombosis, and
aortic branch involvement may potentiate progression from un-TBAD to
complicated TBAD. Short- and long-term outcomes associated with TEVAR
for TBAD remain promising. \textbf{Conclusion} Pre-emptive TEVAR may be
beneficial in patients with un-TBAD presenting with the above factors,
however further prospective research into the optimal timing for TEVAR
in un-TBAD is required.%
\end{abstract}%



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\textbf{Hosted file}

\verb`[Final Copy] Criteria for intervention in TBAD.docx`  available at \url{https://authorea.com/users/397612/articles/552034-criteria-for-endovascular-intervention-in-type-b-aortic-dissection}

\textbf{Hosted file}

\verb`CI TEVAR table risk factors.docx`  available at \url{https://authorea.com/users/397612/articles/552034-criteria-for-endovascular-intervention-in-type-b-aortic-dissection}

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