Specialist TEVAR and ancillary techniques in acute TBAD and IMH (2025)
Description
Authors: A. Chavan and R. Philip Thomas
Reviewers: F. D’Antuono, P. Gkoutzios, T. Kratimenos, R. Uberoi and F. Wolf
This course caters to specialist learners with advanced knowledge in IR.
Abstract
Aortic dissections (AD) and intramural haematomas (IMH) together with penetrated aortic ulcer (PAU) constitute the acute aortic syndrome. Type B aortic dissections (TBAD) constitute 25% to 40% of all aortic dissections. Aortic intramural haematoma (IMH) is a variant defined as a haematoma confined to the medial layer of the aortic wall generally without the presence of a detect-able intimal tear. Acute TBAD and IMH may be uncomplicated or complicated, with complicated TBAD/IMH generally referring to the presence of rupture or impending rupture, refractory pain, or hypertension and malperfusion. The standard of care for uncomplicated TBAD/IMH has been medical management with strict blood pressure control, as open repair has a high morbidity and mortality of up to 31%. In contrast, complicated TBAD/IMH require further treatment, which in the past included surgery. Over the past three decades, minimally invasive endovascular management of these entities has developed rapidly, leading to a change in treatment algorithms for these patients. These techniques include thoracic endovascular aortic repair (TEVAR) for sealing the proximal entry tear, percutaneous fenestration of the intimal flap, and true lumen (TL) stenting. The purpose of this course is to elaborate upon the role of these techniques in the management of acute TBAD and IMH.
Learning objectives
- To learn about the pathophysiology of TBAD/IMH and resultant branch vessel ischaemia
- To learn how to differentiate between uncomplicated and complicated TBAD/IMH
- To become familiar with the various endovascular techniques for the treatment of acute TBAD and IMH
- To learn about the indications and contraindications for intervention
- To determine the most suitable treatment strategy with respect to the underlying pathology
- To learn about the clinical outcome, complications, and possible major adverse events that could be associated with the interventional techniques
Further information
This course is designed for specialists, who have extensive medical experience, having seen at least 200 patients in clinic and completed at least 250 advanced IR procedures in addition to the 150 basic procedures.
The format of the course is interactive and easy to use, including texts, graphics, videos and a quiz to support your learning. The course duration is around three hours and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 3 European CME credits (ECMEC). Please note that this course will be taken offline on November 14, 2030.
The acquired CME Certificate will be available in the myCIRSE area under CIRSE Academy.
The enrolment period of this course is linked to the validity of the All-Access Pass.
Release date: November 2025
