A more proximal landing zone is preferred for thoracic endovascular repair of acute type B aortic dissections

Longer is better, discussing length of coverage and timing of intervention in type B aortic dissection

“…We have found in our own practice that deploying the stent graft proximal to zone 3 was performed in 60% to 70% of our cases. Our practice has been supported by data from Mesar et al, 4 which show that erring on the side of more proximal deployment (zones 2 and 3) is associated with a reduced risk of morbidity and mortality.…”

Treatment for Stanford type B aortic dissection with insufficient anchoring region using castor integrated branched aortic stent graft

“…At present, TEVAR is the first choice for the treatment of TBAD. When the proximal healthy anchoring zone is shorter than 15 mm, the use of conventional aortic covered stent will cause partial or complete occlusion of LSA, which will lead to LSA steal syndrome, higher risk of vascular injury, stent displacement and endoleak ( 3 , 6 – 8 ). LSA provides extensive blood supply to the brain, left upper limb and spinal cord.…”

Gore TAG thoracic branch endograft for treatment of a subacute type B aortic dissection complicated by rupture

“…Coverage of the LSA is often required to achieve a dissection-free proximal seal zone. Mesar et al 15 suggested that patients might benefit from a more aggressive proximal landing zone with similar perioperative morbidity when zone 2 TEVAR is done with LSA revascularization. Open debranching of the LSA will allow for more proximal coverage; however, it is not without complications.…”