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Uncomplicated TBAD patients require prompt medical management to prevent aortic dilatation or rupture during subsequent follow-up. Complicated TBAD patients require immediate invasive management to prevent death or injury caused by rupture or malperfusion. Recent developments in diagnosis and management have reduced mortality related to TBAD considerably. In particular, the introduction of thoracic stent-grafts has shifted the management from surgical to endovascular repair, contributing to a fourfold increase in early survival in complicated TBAD. Furthermore, endovascular repair is now considered in some uncomplicated TBAD patients in addition to optimal medical therapy. For more challenging aortic dissection patients with involvement of the aortic arch, hybrid approaches, combining open and endovascular repair, have had promising results. Regardless of the chosen management strategy, strict antihypertensive control should be administered to all TBAD patients in addition to close imaging surveillance. Future developments in stent-graft design, medical therapy, surgical and hybrid techniques, imaging, and genetic screening may improve the outcomes of TBAD patients even further. We present a comprehensive review of the recommended management strategy based on current evidence in the literature.<\/jats:p>","DOI":"10.1177\/1358863x16642318","type":"journal-article","created":{"date-parts":[[2016,4,11]],"date-time":"2016-04-11T22:10:54Z","timestamp":1460412654000},"page":"251-263","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":88,"title":["Update in the management of type B aortic dissection"],"prefix":"10.1177","volume":"21","author":[{"given":"Foeke JH","family":"Nauta","sequence":"first","affiliation":[{"name":"Thoracic Aortic Research Center, Policlinico San Donato IRCCS, University of Milan, Milan, Italy"},{"name":"Cardiovascular Center, University of Michigan Health System, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santi","family":"Trimarchi","sequence":"additional","affiliation":[{"name":"Thoracic Aortic Research Center, Policlinico San Donato IRCCS, University of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnoud V","family":"Kamman","sequence":"additional","affiliation":[{"name":"Thoracic Aortic Research Center, Policlinico San Donato IRCCS, University of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans L","family":"Moll","sequence":"additional","affiliation":[{"name":"Vascular Surgery Department, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost A","family":"van Herwaarden","sequence":"additional","affiliation":[{"name":"Vascular Surgery Department, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Himanshu J","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University of Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C Alberto","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Departments of Biomedical Engineering and Surgery, University of Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim A","family":"Eagle","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, University of Michigan Health System, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James B","family":"Froehlich","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, University of Michigan Health System, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,4,11]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.072"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2012.11.004"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.015302"},{"key":"e_1_3_2_5_2","first-page":"II312","article-title":"International Registry of Aortic Dissection. 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