Endovascular therapy for aortic dissection

19.4 Conclusion: The recent development of endovascular stent-graft technology and its application as an alternative management strategy to medical therapy or open surgical intervention of patients with aortic dissection is an exciting and potentially valuable advance. As conventional treatments for aortic dissection and its attendant complications are often associated with significant failure rates, result in substantial morbidity and mortality, and/or do little to reduce the risk of aneurysm formation as late sequelae improved treatment options are desired. Here, we have reviewed the current clinical experience with stent-graft placement for treatment of complicated and uncomplicated acute type B dissection, retrograde type A dissection, chronic dissection, and PAU. It is imperative to first appreciate the wide array of clinical, anatomic, and temporal manifestations within the umbrella pathology of aortic dissection. Evaluation of the role of endoluminal stent-graft technology must be performed within the context of each of these subgroups through rigorous, prospective controlled investigations and compared against respective standard treatment. Although this poses a much more significant challenge, the encouraging early results highlighted here underscore the potential for stent-graft therapy to supplant conventional - and often suboptimal - treatment paradigms and to provide patients with a less invasive therapeutic alternative that may concomitantly achieve gains in survival.