BackTable / VI / Podcast / Episode #413

TBAD Management: Best Practices in Aortic Dissection

with Dr. Darren Klass

This week on the BackTable Podcast, Dr. Darren Klass shares his experiences in the treatment of aortic dissections. Dr. Klass is an interventional radiologist at the University of British Columbia.

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Podcast Contributors

Dr. Darren Klass

Dr. Darren Klass is an interventional radiologist and clinical professor with the University of British Columbia in Vancouver, Canada.

Dr. Michael Barraza

Dr. Michael Barraza is a practicing interventional radiologist (and all around great guy) with Radiology Associates in Baton Rouge, LA.

Synopsis

Dr. Klass underscores the criticality of intraoperative decision-making, the use of intravascular ultrasound (IVUS), and the importance of taking a multidisciplinary approach. The conversation further explores the nuances of treating acute complicated aortic dissections, stabilizing the intermedial flap, follow-up protocols, and the importance of raising awareness about this high risk disease.

Timestamps

00:00 - Introduction
07:45 - Identifying and Treating Type B Aortic Dissections
09:35 - Role of Imaging
18:24 - Patient Journey Through Aortic Dissection Treatment
29:35 - Importance of Intravascular Ultrasound
39:01 - Petticoat Technique
47:12 - Role of Lumbar Drains
50:10 - Importance of Follow-ups

Resources

Cook Medical Essential Prescribing Information:
https://www.cookmedical.com/patient-resources/aortic-dissection/aortic-dissection-cook-medical-products/

Dr. Darren Klass’ ResearchGate Profile:
https://www.researchgate.net/profile/Darren-Klass

The Society of Thoracic Surgeons/American Association for Thoracic Surgery Clinical Practice Guidelines on the Management of Type B Aortic Dissection:
https://www.sts.org/sites/default/files/content/TBAD_Guideline_2022.pdf

Krukenberg E. Beiträge zur Frage des Aneurysma dissecans. Beitr Patho Anat Allg Pathol. 1920; 67:329-351. (Paper that first described acute intramural hematoma from 1920):
https://cir.nii.ac.jp/crid/1571698600607606272

Acute Aortic Dissection and Intramural Hematoma: A Systematic Review:
https://pubmed.ncbi.nlm.nih.gov/27533160/

The PETTICOAT Technique for Complicated Acute Stanford Type B Aortic Dissection Using a Tapered Self-Expanding Nitinol Device as Distal Uncovered Stent:
https://pubmed.ncbi.nlm.nih.gov/28279721/

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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Articles

Topics

Intravascular Ultrasound (IVUS) Procedure Prep

Learn about Vascular Surgery on BackTable VI

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