Over the past 2 decades, we have come a long way in our understanding of thoracic aortic dissection, as well as our ability to treat it in its various states. However, it can at times feel as though with each major stone we turn, we find three more. That our greatest recent advancement perhaps lies in our ability to more clearly and accurately classify aortic dissection says a lot about the progress yet to be made in treatment and someday, prevention. We have indeed seen improvement in tailored approaches to type B aortic dissection (TBAD) in particular, and as you will read in this issue of Endovascular Today, this field continues to move forward with research, development, and ingenuity every day in the operating suite.

To begin this issue, Sophia Khan, MD, and Rana O. Afifi, MD, tackle uncomplicated TBAD and the controversy surrounding its management, reviewing its natural history, its relationship to thoracic endovascular aortic repair, high-risk features and risk predictors, and unanswered questions. Shifting to complicated TBAD, Eanas S. Yassa, MD, presents six goals for achieving a structured, consistent approach to management to ensure patients not only survive but thrive postdiagnosis.

Next, Robert A. Larson, MD, considers the TBAD with high-risk features category and how this recognition of risk has affected both the management of these patients and research efforts. We then move to a piece by Andrew W. Hoel, MD, and Mark K. Eskandari, MD, on TBAD patients with identified malperfusion and how specific attention to anatomy and imaging findings can guide endovascular treatment.

Scott Painter, MD; Vamsi K. Potluri, MD; and Carlos F. Bechara, MD, then provide an overview of the current state of type I DeBakey aortic dissection management, looking at current and future technology and technique options as well as the type of center where these patients are best treated.

Closing out our aortic dissection coverage, Jordan R. Stern, MD; Dittmar Böckler, MD; Tara M. Mastracci, MD; and Jean Panneton, MD, share their preferred method for treating the false lumen in the presence of aortic aneurysmal growth in chronic dissection.

This issue also includes a set of articles on radial access. Focusing specifically on lower extremity peripheral artery disease, Kelsey Berger, MD; Krystina Choinski, MD; and Rami Tadros, MD, walk us through their technique for radial access and the highlights and opportunities with current technology options. Then, Dejah R. Judelson, MD; Pascal M. Jabbour, MD; Sudhakar R. Satti, MD; Mike Watts, MD; Manraj K.S. Heran, MD; and Yana Etkin, MD, each ponder their must-haves for the future of radial access, with a particular emphasis on technologic innovations.

Elsewhere in this issue, we share a sneak peek at a radiation safety issue in our sister publication, Cardiac Interventions Today, with a discussion between Drs. Stéphane Manzo-Silberman and Sheila Sahni on radiation exposure misconceptions, specifically concerning pregnancy.

As you can see, when it comes to TBAD, there is still much to explore. We look forward to continuing to uncover new questions, even if we outpace our ability to generate fresh answers. I am grateful for the efforts of each author and the many experts who are dedicating their careers to improving our abilities to treat patients with TBAD, and I look forward to the progress yet to come.

Joseph V. Lombardi, MD, MBA, FACS
Guest Chief Medical Editor