A New Mechanism by Which an Acute Type B Aortic Dissection Is Primarily Complicated, Becomes Complicated, or Remains Uncomplicated

A primary entry tear at the concavity of the distal aortic arch is associated with a significant increase of the occurrence of complicated acute type B aortic dissection. Due to low procedural risk and high success rates, closure of the primary entry tear with thoracic endovascular aortic repair is strongly recommended in this newly defined high-risk subgroup of patients.