Diagnosis and management of thoracic aortic dissection: An update

Table 1 Trials looking at outcomes of type B dissection according to management strategy

Registry	Authors	Design	Indication	Duration	Conclusion
Instead trial	Nienaber et al[37]	Prospective randomised trial	Comparison of TEVAR vs medical therapy in chronic type B dissection	2 yr	TEVAR failed to improve survival or adverse events despite favourable aortic remodeling
Instead-XL	Nienaber et al[39]	Prospective randomised trial	Long-term outcomes of cohorts recruited to INSTEAD trial	5 yr	TEVAR plus best medical therapy improved 5-yr aorta-specific survival
Mother registry	Patterson et al[36]	Collation of data from 5 clinical trials including VIRTUE and INSTEAD	Mid-term outcomes following endovascular repair using TEVAR for acute type B dissection	5 yr	TEVAR provides good midterm protection from aortic-specific pathology High rates of re-intervention
Virtue registry	The Virtue registry investigators[29]	Prospective Multicentre Clinical trial	Safety, performance and health economic data in patients receiving the Valiant endograft	3 yr (2006-2012)	TEVAR provides protection from aortic related death in midterm High rates of re-intervention
Adsorb trial	Hughes[10]	Multicentre randomised clinical trial	Comparison of best medical therapy vs medical therapy and TEVAR for acute type B dissection	1 yr	TEVAR leads to improved aortic remodeling compared to medical therapy alone

TEVAR: Thoracic endovascular repair.