A patient with Type B aortic dissection (Stanford) involving the descending thoracic aorta has persistent chest/back pain, hypertension refractory to medical therapy, and an enlarging aortic diameter on serial CT (48 mm to 55 mm in 3 months). This constitutes which category of Type B dissection mandating intervention?

• A Uncomplicated Type B dissection
• B Complicated Type B dissection ✓
• C Type A dissection misclassified as Type B
• D Marfan-related Type B dissection

Explanation

Complicated Type B aortic dissection includes any of: malperfusion (visceral/renal/limb ischaemia), rupture or impending rupture (rapid expansion > 1 cm/year or > 10 mm in 3 months), refractory pain, refractory hypertension, and early aortic growth. Thoracic endovascular aortic repair (TEVAR) is the treatment of choice for complicated Type B. Uncomplicated Type B is managed medically with goal systolic BP < 120 mmHg.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.