Morphologic predictors of aortic expansion in chronic type B aortic dissection.
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 retrosp...
| Publicado en: | Vascular Vol. 24; no. 2; pp. 187 - 194 |
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| Autores principales: | , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Sage Publications Inc.
Apr2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=113796940&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 113796940 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17085381 0GN jtl: Vascular issn: 17085381 maglogo: N pubinfo: dt: Apr2016 vid: 24 iid: 2 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 113796940 113796940 NLM26079830 10.1177/1708538115591941 NLM26079830 113796940 ppf: 187 ppct: 7 formats: tig: atl: Morphologic predictors of aortic expansion in chronic type B aortic dissection. aug: au: Kotelis, D. Grebe, G. Kraus, P. Müller-Eschner, M. Bischoff, M. von Tengg-Kobligk, H. Böckler, D. affil: Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany sug: subj: Angiography Methods Multidetector Computed Tomography Aortic Aneurysm Aneurysm, Dissecting Prognosis Retrospective Design Middle Age Time Factors Male Predictive Value of Tests Aged Chronic Disease Disease Progression Aortic Aneurysm Therapy Adult Aneurysm, Dissecting Therapy Female Middle Aged: 45-64 years Aged: 65+ years Adult: 19-44 years Male Female ab: 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. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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