Discussion
Due to the increasing incidence rate and high mortality of TBAD in pregnancy, the effective rescue procedures and surgical methods of this disease deserves more concern. To date,there is no specific guideline, and its treatment experiences are mainly based on case series or a synthesis of current published opinions10. While TEVAR has been widely used in complicated TBAD in unpregnant patients and is increasingly being utilized in pregnant patients for aortic repair, the literature lacks consensus regarding whether to conducting TEVAR first or cesarean section. The available literature exhibits divergent treatment options across different medical centers, with some authors advocating for aortic repair surgery first and others approving the priority of caesarean section to avoid the influences of radiation caused by TEVAR on the neonates11-14.Due to the different levels of treatment and the severity of the patient’s condition, it is difficult to evaluate the treatment strategies. Here, we reported clinical data from five patients with complicated TBAD in late second and third trimester. By exploring the optimal strategy for complicated TBD in late pregnancy in clinical practice, we found that TEVAR is safe and feasible. In addition, the strategy of TEVAR first can avoid rupture of aortic dissection caused by delivery, thus improving both maternal and fetal outcomes.