Endovascular Therapy for Thoracic Aortic Dissection and Intramural Hematoma

Endovascular therapy is becoming the standard of care for treating aortic diseases. The continuously evolving technology helps improve new-generation stent grafts and the imaging modalities, so that it is possible to obtain durable results and decrease the amount of complications. The imaging modalities of CT angiography (CTA), transesophageal echocardiography (TEE), and in some cases, MR angiography (MRA), are used preoperatively to give an overview of the anatomy, including the aortic side branches, the landing zone, the angle of the take-off branch vessels, and the entry and re-entry tears. Intraoperatively, fluoroscopy and intravascular ultrasound (IVUS) are widely used. This chapter outlines the steps of endovascular therapy for aortic dissection and intramural hematoma.