The PETTICOAT concept for endovascular treatment of type B aortic dissection

Analysis of the literature data, not only does it demonstrate that the PETTICOAT technique is safe and feasible but also that it is able to enhance the effect of the proximal TEVAR improving the re-expansion of the true lumen of the distal thoraco-abdominal aorta possibly improving end-organ perfusion. However, since there is no evidence of improved short and mid-term survival as well as positive remodeling of the false lumen in the distal aorta, when compared to a simple proximal stent-grafting, a wide-spread use of the PETTICOAT technique is not justified and it should be limited to cases complicated by dynamic malperfusion as a bailout adjunctive tool.