Morphologic predictors of aortic expansion in chronic type B aortic dissection.
Vascular
; 24(2): 187-93, 2016 Apr.
Article
de En
| MEDLINE
| ID: mdl-26079830
ABSTRACT
AIM:
To identify morphologic factors affecting aortic expansion in patients with uncomplicated type B aortic dissections.METHODS:
Computed tomography data of 24 patients (18 male; median age 61 years), diagnosed with acute uncomplicated type B aortic dissections between 2002 and 2013, were retrospectively reviewed. All patients had at least two computed tomography angiography scans and six months of uneventful follow-up. Computed tomography scans were assessed by two independent readers with regard to presence and number of entry tears. Thoracic and abdominal aortic diameters were derived using image processing software.RESULTS:
Twenty-two of 24 patients showed aortic expansion over a median computed tomography angiographic follow-up of 33.2 months. Annual rates showed an increase of 1.7 mm for total aortic diameter, 2.1 mm for the false and a decrease of -0.4 mm for the true lumen. In three patients (12.5%), aortic diameter exceeded 60 mm during follow-up, and all three patients underwent thoracic endovascular aortic repair. Patients with a maximum aortic diameter <4 cm at baseline showed a significantly higher expansion rate compared to cases with an initial maximum aortic diameter of ≥4 cm (p=0.0471). A median of two entries (range 1-5) was recognized per patient. Presence of more than two entry tears (n = 13) was associated with faster overall diameter expansion (mean annual rates 2.18 mm vs. 1.16 mm; p = 0.4556), and decrease of the cross-sectional surface of the true lumen over time (annual rate for > 2 entries vs. ≤2 entries -7.8 mm2 vs. +37.5 mm2; p = 0.0369). Median size of entry tears was 12 mm (range 2-53 mm).CONCLUSIONS:
The results presented herein suggest that uncomplicated type B aortic dissection patients with more than two entry tears and/or an initial maximum aortic diameter of<4 cm are at risk for aortic dilatation and, therefore, may require stricter follow-up including the possible need for early intervention.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Anévrysme de l'aorte
/
Aortographie
/
Tomodensitométrie multidétecteurs
/
Angiographie par tomodensitométrie
/
Type d'étude:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
Vascular
Sujet du journal:
ANGIOLOGIA
/
CARDIOLOGIA
Année:
2016
Type de document:
Article
Pays d'affiliation:
Allemagne