Ep. 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. 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. --- CHECK OUT OUR SPONSOR Cook Medical Aortic Interventions https://www.cookmedical.com/aorticbacktable --- SHOW NOTES 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/