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We thank Ueki and Sakaguchi [1Ueki C. Sakaguchi G. Is the complication-specific approach adequate for acute type B aortic dissection? (letter).Ann Thorac Surg. 2016; 102: 348-349Abstract Full Text Full Text PDF Scopus (1) Google Scholar] for their interest in our recent paper on the experience with the complication-specific approach (CSA) for acute Type B aortic dissection (TBAD) [2Charilaou P. Ziganshin B.A. Peterss S. et al.Current experience with acute type B aortic dissection: validity of the complication-specific approach in the present era.Ann Thorac Surg. 2016; 101: 936-944Abstract Full Text Full Text PDF Scopus (32) Google Scholar]. We are aware of the important contribution that this group has made in identifying prognostic factors for patients with TBAD [3Ueki C. Sakaguchi G. Shimamoto T. Komiya T. Prognostic factors in patients with uncomplicated acute type B aortic dissection.Ann Thorac Surg. 2014; 97 (discussion 773): 767-773Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar]. Below we address the points that were raised. Our study included all consecutive patients with acute TBAD who presented to our institution over a 15-year period. This included both complicated and uncomplicated acute TBAD cases. Upon admission, all patients were initially triaged by the CSA to either medical (uncomplicated TBAD) or surgical or endovascular management (complicated TBAD). Complicated TBAD patients were defined as either presenting with a complication or developing a complication within the first 14 days of onset (14 days is widely accepted as the acute period for aortic dissection). Specifically, such complications as aortic expansion or impending rupture can only be observed longitudinally over a period of time. We feel this longitudinal analysis over the course of the initial hospitalization is clinically useful. We agree that in-depth analysis into the predictors of delayed complications (eg, detailed radiological data on the false lumen status, location of the entry tear, other factors) is important for future studies. The main point that our study conveys is that the majority of patients with an uncomplicated course of TBAD do well in both early (100% of patients survived the initial hospitalization) and late follow-up (70% of patients required no further surgical intervention) with medical therapy alone. The long-term survival of these uncomplicated patients at 6 years postdissection is no different than the expected survival of an age- and gender-matched normal population [2Charilaou P. Ziganshin B.A. Peterss S. et al.Current experience with acute type B aortic dissection: validity of the complication-specific approach in the present era.Ann Thorac Surg. 2016; 101: 936-944Abstract Full Text Full Text PDF Scopus (32) Google Scholar]. We feel that with the increasing popularity of endovascular techniques, our study provides a healthy reference for comparison of outcomes. Is the Complication-Specific Approach Adequate for Acute Type B Aortic Dissection?The Annals of Thoracic SurgeryVol. 102Issue 1PreviewWe read with great interest the article by Charilaou and colleagues [1], which reported outcomes of complicated and uncomplicated acute type B aortic dissection (TBAD). However, several issues regarding this study need to be discussed. Full-Text PDF