Dr. Kougias Co-Authors Authoritative NEJM Review on Life-Threatening Aortic Condition

By Office of the President | Oct 21, 2025

Downstate continues to earn distinction in academic medicine with the recent publication of a significant New England Journal of Medicine (NEJM) review co-authored by Panos Kougias, M.D., MSc FACS, Professor in the Department of Surgery. The article, “Management of Acute Type B Aortic Dissection,” was published in the September 4, 2025, issue of NEJM, one of the most cited and influential medical journals in the world.

Co-authored with Firas F. Mussa, M.D., MS, FACS, McGovern Medical School at UTHealth Houston, the article provided an authoritative synthesis of the current evidence guiding the diagnosis and treatment of acute type B aortic dissection (TBAD). This life-threatening cardiovascular emergency affects approximately 13,000 people each year in the United States. Their work emphasizes the importance of rapid diagnosis, blood-pressure control, and the growing role of thoracic endovascular aortic repair (TEVAR) in improving patient survival.

The authors offer a detailed discussion of evolving clinical approaches to both complicated and uncomplicated TBAD, clarifying key decision points in patient management and highlighting gaps in evidence that demand further research. It emphasizes multidisciplinary care and long-term imaging surveillance as essential elements of successful outcomes.

Dr. Kougias’s contributions to this review reflect his national expertise in vascular and endovascular surgery, particularly in the management of complex aortic disease. His scholarship continues to elevate Downstate’s growing reputation as a center for cardiovascular innovation and translational science.

The NEJM review provides clinicians with an updated framework for assessing surgical risk, integrating imaging technology, and optimizing long-term patient outcomes. It also outlines new frontiers in the management of high-risk and genetically triggered thoracic aortic disease—areas where Dr. Kougias continues to lead innovative inquiry.

Drs. Kougias and Mussa are among the national Primary Investigators of the IMPROVE-AD trial, whose objective is to compare best medical management vs. TEVAR in patients with uncomplicated type B aortic dissection.

The full article, “Management of Acute Type B Aortic Dissection” (N Engl J Med 2025; 393:895–905), is available through the New England Journal of Medicine at www.nejm.org.