Distal Aortic Remodeling Using Endovascular Repair in Acute DeBakey I Aortic Dissection

DeBakey type I aortic dissections pose significant challenges in operative and long-term management of the arch and distal thoracic aorta. Concerns regarding management of complex tears extending to the arch and descending thoracic aorta, malperfusion syndromes, and late aortic dilatation have provided an impetus to explore aortic repairs that involve stent-graft placement into the descending thoracic aorta in combination with conventional hemi-arch or total arch repairs. Early results with these techniques are promising but further study is warranted.