ESC PAAD 2024 — 2024 ESC Guidelines for the Management of Peripheral Arterial and Aortic Diseases

Type A acute aortic dissection requires emergent surgical repair. For uncomplicated Type B dissection, initial optimal medical (anti-impulse) therapy is the foundational strategy; for uncomplicated Type B dissection with anatomy favorable for endovascular repair, TEVAR in the subacute phase is recommended (Class IIa, Level of Evidence B). For complicated Type B dissection with favorable anatomy, endovascular repair is recommended (Class I, Level of Evidence B), with open surgery as an alternative when anatomy is unsuitable. Selected uncomplicated patients with high-risk anatomical features (e.g., larger aortic or false-lumen diameter, larger entry tear) may be considered for individualized, multidisciplinary pre-emptive TEVAR rather than on the basis of the feature alone.