From acute to chronic aortic dissection

This PVI 2025 replay explores the full spectrum of aortic dissection management, from acute presentation to long-term chronic follow-up, with a focus on evolving endovascular strategies and decision-making.

Through the case of a 16-year-old patient with complicated acute thoraco-abdominal dissection and reno-visceral malperfusion, the discussion highlights how management of hereditary thoracic aortic disease must be tailored to anatomy, life expectancy, and treatment horizons, while endograft technology and implantation techniques continue to evolve for this complex population.

The session then critically reviews the evidence behind “high-risk features” in uncomplicated acute type B dissection, questioning the quality and reproducibility of the data that has influenced current guidelines. 

It further addresses follow-up strategies, optimal management of the false lumen in chronic dissections, and the role of septotomy as a useful adjunct in selected anatomies, with emphasis on safety and proper imaging guidance.

By watching this replay, you will learn how to identify patients requiring early endovascular repair, design tailored follow-up protocols for type B dissection, and implement a structured workflow for safe F/B-EVAR in chronic dissections.