STS/AATS Release New Guidelines for Type B Aortic Dissection

The Society of Thoracic Surgeons (STS) and American Association of Thoracic Surgery (AATS) have published new clinical practice guidelines for the management of patients with type B aortic dissection (TBAD).

Published on January 25, the guideline provides insight into management of TBAD, including the role of earlier endovascular treatment such as thoracic endovascular aortic repair (TEVAR) in patients with uncomplicated TBAD and providing other evidence-based recommendations, including use of a stepwise approach to evaluation and management of patients with uncomplicated TBAD followed by close clinical surveillance.

“There has been an explosion of information in the form of research reports of varying quality regarding the treatment of type B dissection over the past decade,” said author G. Chad Hughes, MD, from Duke University Medical Center, in a statement from the STS. “This guideline is unique in providing surgeons with a comprehensive, up-to-date summary of the state of the evidence, while also serving as ‘guard rails’ that outline treatment options and best practices in certain scenarios. This is a first for any document in the field of type B dissection management.”

Composed by Hughes and a team of 18 colleagues representing institutions across the US, the 20-page guideline recommendation was created to reflect contemporary data in the diagnosis and treatment of TBAD from a group of 50 highly cited articles included in the guideline committee’s final review. The guideline includes multiple class I recommendations. These included using a stepwise approach to the evaluation and treatment of patients with TBAD followed by close clinical surveillance, optimal medical therapy remains the recommended treatment for patients with uncomplicated TBAD, and TEVAR being indicated for complicated hyperacute, acute, or subacute TBADs.

For more highlights from the STS/AATS TBAD guidelines, check out the slideshow below:

“We expect this guideline to improve the quality of care of patients with TBAD by providing surgeons the most up-to-date summary of when and how to effectively use which therapies, whether open surgery, endovascular therapy, or a combination of the two over the lifetime of the patient,” said author Dawn S. Hui, MD, from The University of Texas Health Science Center at San Antonio, in the aforementioned statement.

This guideline recommendation, “The Society of Thoracic Surgeons/American Association for Thoracic Surgery Clinical Practice Guidelines on the Management of Type B Aortic Dissection,” was published in The Annals of Thoracic Surgery and The Journal of Thoracic and Cardiovascular Surgery.