Work

Beyond Anatomy in Uncomplicated Type B Aortic Dissection: Hypoxia, Physiological Reserve, and the Next Generation of Intelligent Endovascular Devices

Year: 2026

Type: review

Abstract: Type B aortic dissection (TBAD) represents a heterogeneous disease process that cannot be fully understood through anatomy alone. Although the majority of patients initially meet current criteria for uncomplicated TBAD (uTBAD), a substantial proportion later progresses despite appearing stable during early assessment and surveillance. The mechanisms underlying this deterioration remain incompletely understood and extends beyond our current understanding of traditional anatomic high-risk criteria. This article examines impaired oxygenation and physiological reserve as potential dimensions of clinical vulnerability in uTBAD, while distinguishing their possible relevance to acute deterioration from their unproven value in predicting aortic progression or selecting patients for intervention. As such, TBAD is not simply a focal vascular event, but a disease with broader systemic and physiological implications. It also discusses how future intelligent endovascular technologies could support a more personalised approach to management by integrating embedded sensors, wireless physiological monitoring, and artificial intelligence-assisted haemodynamic analysis. Moreover, a conceptual framework is discussed in which the stent graft evolves from a purely mechanical device into an active therapeutic platform capable of physiological sensing and real-time feedback.

Source: Medical Devices Evidence and Research

DOI: 10.2147/mder.s636743