Thoracic Endovascular Repair in Acute Type B Aortic Intramural Haematoma: Is It Really Better To Fix What Is Broken?

In the current meta-analysis including a total of eight observational studies Pompeu Sá and colleagues report the pooled data of patients who underwent thoracic endovascular aortic repair (TEVAR; n = 440) or best medical therapy (BMT; n = 575) for acute type B intramural haematoma (IMH).1 After a median follow up of 5.1 years TEVAR was associated with a reduced all cause (HR 0.44, 95% CI 0.30 – 0.65, p < .001) and aortic related (HR 0.04, 95% CI 0.01 – 0.31, p = .002) mortality. The authors therefore cautiously conclude that TEVAR might lead to a lower risk of all cause and aortic specific mortality in patients with type B IMH compared with BMT alone.