Delivery of Optimum Management of Type B Aortic Dissection in the UK: Sum of All Fears!

Abstract

Introduction: This review aims to summarise the current trend and practice for management of Type B aortic dissection (TBAD) across the UK. We also aim to highlight the service specification and configuration as well as the current portrayed outcomes published from different sources within the UK. Methods: We carried out a comprehensive literature search on multiple electronic databases including PUBMED, Scopus and EMBASE in order to collate all research evidence on TBAD service line in the UK. We also navigated through official reports published from different sources within the UK specifically highlighting aortic dissection. Results: The UK’s research into TBAD falls short when compared to international counterparts due to a lack of evidence related to TBAD incidence and outcomes. Some TBAD patients are managed at unspecialised centres and others are lost to follow-up. The UK’s vascular surgery workforce is expanding at a very slow rate and the specialised aortic units are consistently failing to meet the waiting time standards for treatment. Conclusions: Restructuring and service reconfiguration are imperative for outcome reporting for TBAD affected population cohort. TBAD should be centralised towards hospital with concentrated level of experience and expertise.