# Christoph Nienaber

**Christoph A. Nienaber** is a cardiologist and interventional cardiovascular specialist who has worked as a consultant cardiologist at Royal Brompton Hospital in London since May 2015, focusing on the diagnosis and non-surgical treatment of aortic diseases such as aneurysm and aortic dissection.<sup>[1](https://www.rbht.nhs.uk/specialists/professor-christoph-nienaber)</sup> He is a co-founder of the International Registry of Acute Aortic Dissection (IRAD) and has pioneered endovascular techniques for aortic dissection, initiating and participating in guideline-changing trials.<sup>[1](https://www.rbht.nhs.uk/specialists/professor-christoph-nienaber)</sup>

| | |
|---|---|
| **Field** | Cardiology, interventional treatment of aortic disease<sup>[1](https://www.rbht.nhs.uk/specialists/professor-christoph-nienaber)</sup> |
| **Current role** | Consultant cardiologist, Royal Brompton Hospital, London, since May 2015<sup>[1](https://www.rbht.nhs.uk/specialists/professor-christoph-nienaber)</sup> |
| **Rostock chair** | Head of internal medicine and cardiology, Universitätsmedizin Rostock, from 1 December 2000 to May 2015<sup>[1](https://www.rbht.nhs.uk/specialists/professor-christoph-nienaber)</sup><sup> • </sup><sup>[3](https://www.abitur-und-studium.de/Personen/Christoph-Nienaber)</sup> |
| **Signature work** | "Nonsurgical Reconstruction of Thoracic Aortic Dissection by Stent–Graft Placement", New England Journal of Medicine, 1999<sup>[4](https://doi.org/10.1056/nejm199905203402003)</sup> |
| **Registry** | Co-founder of IRAD, the International Registry of Acute Aortic Dissection<sup>[1](https://www.rbht.nhs.uk/specialists/professor-christoph-nienaber)</sup> |
| **Guidelines** | Author of the 2020 EACTS/ESC consensus on type B aortic dissection and the 2024 EACTS/STS aortic guidelines<sup>[5](https://iris.unibas.it/bitstream/11563/190103/2/CL%20124%20Czerny%20EJCTS%202020%20Document.pdf)</sup><sup> • </sup><sup>[6](https://dgthg.de/inhalt/uploads/2025/02/2024_ezad426.pdf)</sup> |
| **Recent activity** | ESC educational sessions in August 2026; a paper in Annals of Cardiothoracic Surgery in July 2026<sup>[7](https://esc365.escardio.org/person/149407)</sup><sup> • </sup><sup>[8](https://www.annalscts.com/article/view/17635/html)</sup> |

## Training and career

Nienaber completed his medical state examination at Westfälische Wilhelms-Universität Münster in 1980.<sup>[2](https://www.topdoctors.co.uk/doctor/christoph-nienaber/)</sup> He is a certified internist, cardiologist, and interventional cardiovascular specialist.<sup>[1](https://www.rbht.nhs.uk/specialists/professor-christoph-nienaber)</sup>

His academic career developed at [University Medical Center Hamburg-Eppendorf](https://www.edgepedia.org/university-medical-center-hamburg-eppendorf), where he also undertook a temporary post at UCLA School of Medicine.<sup>[1](https://www.rbht.nhs.uk/specialists/professor-christoph-nienaber)</sup> According to abitur-und-studium.de, in December 2000 he was appointed chief of internal medicine and cardiology at Universitätsmedizin Rostock, taking up the post on 1 December 2000.<sup>[3](https://www.abitur-und-studium.de/Personen/Christoph-Nienaber)</sup> During his Rostock years the university opened the Herzzentrum des Universitätsklinikums Rostock in 2010, where he served as head of the cardiology department.<sup>[3](https://www.abitur-und-studium.de/Personen/Christoph-Nienaber)</sup> 

His interventional practice includes transcatheter aortic valve implantation, thoracic endovascular aortic repair (TEVAR), left-atrial appendage occlusion, closure of patent foramen ovale and atrial septal defect, and non-surgical management of aortic coarctation.<sup>[1](https://www.rbht.nhs.uk/specialists/professor-christoph-nienaber)</sup> 

## Representative work

In ["Nonsurgical Reconstruction of Thoracic Aortic Dissection by Stent–Graft Placement"](https://doi.org/10.1056/nejm199905203402003), published in the New England Journal of Medicine on 20 May 1999, 12 patients with type B aortic dissection received endovascular stent-grafts and were compared with 12 matched surgical controls. Stent-graft placement resulted in no morbidity or mortality, whereas surgery was associated with four deaths (33 percent, P=0.09) and five serious adverse events (42 percent, P=0.04) within 12 months.<sup>[4](https://doi.org/10.1056/nejm199905203402003)</sup> Sealing of the entry tear was monitored during the procedure, and thrombosis of the false lumen was confirmed in all 12 stent-graft patients after a mean of three months by magnetic resonance imaging, with no deaths, paraplegia, stroke, embolization, side-branch occlusion, or infection in that group.<sup>[4](https://doi.org/10.1056/nejm199905203402003)</sup> The authors concluded that elective, nonsurgical insertion of a stent-graft is safe and efficacious in selected patients for whom surgery is indicated, recommending it only for patients with an indication for surgical repair and suitable anatomy.<sup>[4](https://doi.org/10.1056/nejm199905203402003)</sup>

His review ["Aortic Dissection: New Frontiers in Diagnosis and Management"](https://doi.org/10.1161/01.cir.0000087009.16755.e4) is another of his works on the diagnosis and management of aortic dissection.

## IRAD and collaborative research

Nienaber is a co-founder of IRAD, a global network for acute aortic conditions; the [European Society of Cardiology](https://www.edgepedia.org/european-society-of-cardiology)'s faculty record describes him as its founding father and records its development over 27 years.<sup>[1](https://www.rbht.nhs.uk/specialists/professor-christoph-nienaber)</sup><sup> • </sup><sup>[7](https://esc365.escardio.org/person/149407)</sup> Through the registry he initiated and participated in trials that changed guidelines.<sup>[1](https://www.rbht.nhs.uk/specialists/professor-christoph-nienaber)</sup>

An IRAD analysis of 900+ consecutive patients with type B acute aortic dissection enrolled between 1995 and 2012 found that about 700 (roughly 75%) received medical therapy and about 200 (roughly 25%) TEVAR; in-hospital mortality was similar (about 11% endovascular versus about 9% medical, p=0.273).<sup>[10](https://www.sciencedirect.com/science/article/pii/S1936879813009916)</sup> At five years, however, Kaplan-Meier survival estimates showed a lower death rate with TEVAR (about 12%) than with medical therapy (about 23%, p=0.018), while aortic growth or new aneurysm during follow-up occurred in about 60% of medically treated patients and about 50% after TEVAR.<sup>[10](https://www.sciencedirect.com/science/article/pii/S1936879813009916)</sup> 

## How his work changed practice

Nienaber performed his first TEVAR in type B dissection in 1996 and his first TEVAR in acute type A dissection in 2009.<sup>[11](https://divine-id.agency/Critical-Issues/2016/NIENABER.pdf)</sup> The 1999 feasibility paper was followed by a randomized trial. At 2 years, cumulative survival was 95.6±2.5% with medical therapy versus 88.9±3.7% with TEVAR (P=0.15); the trial was underpowered, and TEVAR failed to improve 2-year survival and adverse event rates despite favorable aortic remodeling, which occurred in 91.3% of TEVAR patients versus 19.4% of medically treated patients (P<0.001).<sup>[12](https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.109.886408)</sup> The five-year analysis told a different story: all-cause mortality was 11.1% with TEVAR versus 19.3% with medical therapy alone (P=0.13), aorta-specific mortality 6.9% versus 19.3% (P=0.04), and disease progression 27.0% versus 46.1% (P=0.04), with improved survival and less progression associated with stent-graft-induced false lumen thrombosis in 90.6% of cases (P<0.0001).<sup>[14](https://doi.org/10.1161/circinterventions.113.000463)</sup>

His 2015 review ["[Management](https://www.edgepedia.org/management) of acute aortic dissection"](https://doi.org/10.1016/s0140-6736(14)61005-9) was published in [The Lancet](https://www.edgepedia.org/the-lancet) on 1 February 2015.<sup>[15](https://doi.org/10.1016/s0140-6736(14)61005-9)</sup>

Guidelines have moved with the evidence. The 2020 EACTS/ESC expert consensus, on which Nienaber is an author from the Department of Cardiology, Royal Brompton Hospital, states that use of TEVAR in acute complicated type B aortic dissection is established and that benefit in uncomplicated type B dissection has been documented by randomized trials.<sup>[5](https://iris.unibas.it/bitstream/11563/190103/2/CL%20124%20Czerny%20EJCTS%202020%20Document.pdf)</sup> According to the 2022 STS/AATS Clinical Practice Guidelines on the Management of Type B Aortic Dissection, optimal medical therapy is recommended for uncomplicated type B dissection, and TEVAR (Class I, LOE B-NR) for complicated hyperacute, acute, or subacute disease with rupture or malperfusion and favorable anatomy; the guideline also holds open surgical repair reasonable over TEVAR as a more durable treatment in connective tissue disorder patients with disease progression despite optimal medical therapy.<sup>[16](https://www.sts.org/sites/default/files/content/TBAD_Guideline_2022.pdf)</sup> 

Where debate remains: the German interdisciplinary guideline notes that TEVAR is recommended as first-line treatment (class I, level C) in the current ESC guidelines for acute complicated type B dissection, but that there have not yet been any randomized trials comparing endovascular and open repair in acute complicated type B dissections.<sup>[17](https://pmc.ncbi.nlm.nih.gov/articles/PMC10123596/)</sup> A 2022 review states that open surgical repair remains the gold standard of treatment for dissections located to the proximal part of the aorta and the arch.<sup>[18](https://pmc.ncbi.nlm.nih.gov/articles/PMC9605578/)</sup> According to the 2024 ESC Guidelines for the management of peripheral arterial and aortic diseases, the guidelines carry updated recommendation tables for chronic type B aortic dissection, merging the 2017 peripheral arterial disease and 2014 aortic disease guidelines.<sup>[19](https://dipot.ulb.ac.be/dspace/bitstream/2013/378786/3/ehae179.pdf)</sup> 

## Recent work

Nienaber was a co-author of the 2024 EACTS/STS guidelines for diagnosing and treating acute and chronic syndromes of the aortic organ, published in the European Journal of Cardio-Thoracic Surgery.<sup>[6](https://dgthg.de/inhalt/uploads/2025/02/2024_ezad426.pdf)</sup> He contributed ESC educational content as recently as August 2026, including "Guidelines in Practice: aortic dissection" (30 August 2026) and "Aortic medicine: progress, gaps, and perspectives" (29 August 2026).<sup>[7](https://esc365.escardio.org/person/149407)</sup> In July 2026 he was a co-author of "The aortic window: a temporal framework for acute type A aortic dissection", published online 31 July 2026 in Annals of Cardiothoracic Surgery.<sup>[8](https://www.annalscts.com/article/view/17635/html)</sup>
## References


1. [Professor Christoph Nienaber | Royal Brompton & Harefield hospitals](https://www.rbht.nhs.uk/specialists/professor-christoph-nienaber)
2. [Professor Christoph Nienaber - Top Doctors](https://www.topdoctors.co.uk/doctor/christoph-nienaber/)
3. [Christoph Nienaber - abitur-und-studium.de (press archive)](https://www.abitur-und-studium.de/Personen/Christoph-Nienaber)
4. [Nonsurgical Reconstruction of Thoracic Aortic Dissection by Stent–Graft Placement (N Engl J Med 1999)](https://doi.org/10.1056/nejm199905203402003)
5. [EACTS/ESC expert consensus document on type B aortic dissection (2020)](https://iris.unibas.it/bitstream/11563/190103/2/CL%20124%20Czerny%20EJCTS%202020%20Document.pdf)
6. [EACTS/STS Guidelines for diagnosing and treating acute and chronic syndromes of the aortic organ (EJCTS 2024)](https://dgthg.de/inhalt/uploads/2025/02/2024_ezad426.pdf)
7. [ESC 365 - Professor Christoph Nienaber](https://esc365.escardio.org/person/149407)
8. [The aortic window: a temporal framework for acute type A aortic dissection - Annals of Cardiothoracic Surgery](https://www.annalscts.com/article/view/17635/html)
9. [Komplexe Behandlungseinheit: Rostock hat ersten universitären Hybrid-OP](https://www.abitur-und-studium.de/Blogs/Universitaet-Rostock/Komplexe-Behandlungseinheit-Rostock-hat-ersten-universitaeren-Hybrid-OP)
10. [Survival After Endovascular Therapy in Patients With Type B Aortic Dissection: A Report From IRAD (JACC Cardiovasc Interv, 2013)](https://www.sciencedirect.com/science/article/pii/S1936879813009916)
11. [Endovascular Treatment of Aortic Dissection – A Changing Landscape (C. A. Nienaber lecture slides)](https://divine-id.agency/Critical-Issues/2016/NIENABER.pdf)
12. [Randomized Comparison of Strategies for Type B Aortic Dissection: The INSTEAD Trial (Circulation 2009)](https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.109.886408)
13. [Investigation of Stent-grafts in Aortic Dissection (INSTEAD), ClinicalTrials.gov](https://clinicaltrials.gov/study/NCT01415804)
14. [Endovascular Repair of Type B Aortic Dissection (Circ Cardiovasc Interv, 2013)](https://doi.org/10.1161/circinterventions.113.000463)
15. https://doi.org/10.1016/s0140-6736(14)61005-9
16. [STS/AATS Clinical Practice Guidelines on the Management of Type B Aortic Dissection (2022)](https://www.sts.org/sites/default/files/content/TBAD_Guideline_2022.pdf)
17. [Interdisciplinary German clinical practice guidelines on the management of type B aortic dissection](https://pmc.ncbi.nlm.nih.gov/articles/PMC10123596/)
18. [Current Understanding of Aortic Dissection (Life, 2022)](https://pmc.ncbi.nlm.nih.gov/articles/PMC9605578/)
19. [2024 ESC Guidelines for the management of peripheral arterial and aortic diseases](https://dipot.ulb.ac.be/dspace/bitstream/2013/378786/3/ehae179.pdf)



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*Topic: Encyclopedia › Life and health › Life and health scientists › Medical and health researchers › Researchers in cardiovascular, metabolic, and endocrine research › Interventional cardiology researchers*

*Initially written Sep 21, 2026 · Reviewed: Sep 25, 2026 · Edited: Sep 25, 2026 · Last review: Sep 25, 2026*

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License: Edgepedia Community License 1.0, https://www.edgepedia.org/edgepedia/license