The aortic dissection is the most common emergency in the area of the large artery (aorta). This leads to a tearing of the inner vessel wall (intima) with blood flow in the wall, which usually ransacked back into the interior of the vessel. The type B dissection, in which the tear occurs far away from the ascending thoracic aorta (aorta ascendens), accounts for approximately 30% of all aortic dissection. Relative to Germany, the incidence is approximately 2 cases per 100,000 inhabitants.
Risk factors for type B dissection are:
While type A dissection (involving Aorta ascendens) usually requires emergency cardiac surgery, type B dissection is only invasively treated when complications occur.
Nowadays, catheter treatment is the method of choice should there be a complicated type-B dissection. Only timely diagnosis and therapy can save lives. In many cases this includes the preparatory bypass diversion of the cervical arteries in order to create a favorable "landing zone" for the stenosis. Despite modern therapies, hospital mortality is high at almost 20%.