Uncomplicated Type B Aortic Dissection: Challenges in Diagnosis and Categorization

Acute type B aortic dissection (TBAD) is a rare disease that is likely under-diagnosed in the UK. As a progressive, dynamic clinical entity, many patients initially diagnosed with uncomplicated TBAD deteriorate, developing end-organ malperfusion and aortic rupture (complicated TBAD). An evaluation of the binary approach to the diagnosis and categorisation of TBAD is needed.A narrative review of the risk factors predisposing patients to progression from unTBAD to coTBAD was undertaken.Key high-risk features predispose the development of complicated TBAD, such as maximal aortic diameter > 40 mm and partial false lumen thrombosis.An appreciation of the factors that predispose to complicated TBAD would aid clinical decision-making surrounding TBAD.