As the indications for thoracic endovascular aortic repair (TEVAR) in the treatment of type B aortic dissection continue to expand, whether and when patients with uncomplicated Stanford type B aortic dissection (uTBAD) should undergo preemptive TEVAR have become pressing clinical questions. Although uTBAD is not accompanied by complications such as rupture or malperfusion during the acute phase, some patients develop persistent false lumen perfusion, aortic dilatation, and late aorta-related events during follow-up, resulting in heterogeneous long-term outcomes. Therefore, avoiding overtreatment in low-risk patients while accurately identifying high-risk patients who may benefit from intervention is essential for improving long-term aortic outcomes. This review first analyzes the optimal timing of preemptive TEVAR based on disease staging, pathological changes in the aortic wall, and current clinical evidence, with particular emphasis on the rationale for the subacute phase as a potential treatment window. It then summarizes the clinical features, morphological characteristics on CTA, false lumen status, and dynamic imaging assessment methods associated with high-risk uTBAD. Finally, it highlights the need to develop multimodal predictive models to enable more precise patient selection and individualized intervention.

Renzhe Wang, Zhixiang Liao, Birun Huang. Advances in Preemptive TEVAR for Uncomplicated Type B Aortic Dissection. Frontiers in Medical Science Research (2026), Vol. 8, Issue 4: 61-71. https://doi.org/10.25236/FMSR.2026.080408.

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