Growth Rate of Aortic Diameter in Post Treatment of Aortic Dissection.

ABSTRACT

OBJECTIVE: To evaluate growth rate of aortic diameter true lumen, and false lumen in post endovascular aortic repair of aortic dissection. MATERIAL AND METHOD: Between January 2005 and September 2010, 48 consecutive patients with aortic dissection were followed with computed tomographic angiography (CTA), including 18 post-surgical repaired type A patients and 30 type B (14 conservative treatment and 16 post stent-grafting therapy). CTA were performed with a mean of 5.2 scans per patient, and a meanfollow-up of 37.08 months. The diameter ofthe aorta, true lumen, andfalse lumen were measured by axial scan images and multi-planar reformatting (MPR). RESULTS: In medically managed patients with type B aortic dissection, the aortic diameter increased over time at mean rate 1.49 mm/year at proximal descending aorta with greater increased in size ofthe false lumen diameters than the true lumen diameter. In post-surgical repaired type A and post stent-grafting therapy type B aortic dissection, aortic diameter did not change over time. In addition, 12 of 16 patients (75%)patients with post stent-grafting therapy type B dissection hadpartial thrombosed in false lumen and 4 of 16 patients (25%) had complete resolution offalse lumen. CONCLUSION: In post-surgical repaired type A and post stent-grafting therapy type B aortic dissection, aortic diameter did not change over time. Type B aortic dissection with medical treatment had minimal increased in aortic diameter over time. The results suggested that uncomplicated type B aortic dissection requires on-going medical treatment.