The Evaluation Characteristics of Type B Aortic Intramural Hematoma and Ten Years Treatment Outcomes
Open Access
- 1 January 2021
- journal article
- research article
- Published by Scientific Research Publishing, Inc. in World Journal of Cardiovascular Diseases
- Vol. 11 (01), 58-68
- https://doi.org/10.4236/wjcd.2021.111008
Abstract
Background: Type B aortic intramural hematoma (IMH-B) is recognized as a subset of aortic dissection. The evolution of uncomplicated IMH-B is very difficult to predict. How and when to deal with this disease is unclear. The present study constructed two models to explore this problem. One is the morphology evolution model, which explored the risk factors and predictors for the IMH-B patients. Another is the predictive model confirmed the predictors and the time for invasive treatment of uncomplicated IMH-B patients. Objective: To explore the evolution predictors and detect the time for invasive treatment of uncomplicated IMH-B patients. Methods: Themorphology evolution model demonstrated that all 81 patients were diagnosis with CTA images. The initial and follow-up data were retrospectively studied. The evolution data were collection and measurement from initial and follow-up CTA images data. The predictive model showed that predictors of progression were detected with cox regression analysis. Results: All 81IMH-B patients were followed-up ranged from 1.2 to 36 months (median, 22 months). 26 patients accepted invasive treatment (24 underwent TEVAR and 2 underwent Surgery). 55 patients received medical treatment. Invasive treatment (IT) group overall events are 1/26 (3.8%); medical treatment (MT) group overall events are 33/55 (60.0%); IT group vs. MT group: p . Moreover, we found that most events related aorta occurred within 30 days. Multivariate Cox regression analysis MDAD (hazard ratio, 3.58; 95% CI, 1.25- 5.78; p - 7.84; p - 5.63; p Conclusions: MDAD > 45 mm, MDAHT > 10 mm, and IMH with PAU may be the important predictors for uncomplicated IMH-B patients. Most adverse aorta related events occurred within 30 days. It would be careful follow-up, closely observe for these patients within 30 days, and take necessary treatment strategies in time.Keywords
This publication has 14 references indexed in Scilit:
- Acute type B aortic intramural hematoma: the added prognostic value of a follow-up CTEuropean Radiology, 2019
- Cardiovascular morbidity and mortality after aortic dissection, intramural hematoma, and penetrating aortic ulcerJournal of Vascular Surgery, 2019
- Five-year outcomes after thoracic endovascular aortic repair of symptomatic type B penetrating aortic ulcer with intramural hematoma in Chinese patientsJournal of Thoracic Disease, 2019
- Penetrating Aortic Ulcer and Intramural HematomaCardioVascular and Interventional Radiology, 2018
- Management strategies in acute type B aortic intramural hematomaCurrent Opinion in Cardiology, 2017
- Prognostic significance of early aortic remodeling in acute uncomplicated type B aortic dissection and intramural hematomaThe Journal of Thoracic and Cardiovascular Surgery, 2017
- Treatment indications for and outcome of endovascular repair of type B intramural aortic hematomaJournal of Vascular Surgery, 2016
- Acute Intramural Hematoma of the AortaJournal of the American College of Cardiology, 2005
- Clinical features and long-term outcome of type A and type B intramural hematoma of the aortaThe Journal of Thoracic and Cardiovascular Surgery, 2004
- Midterm follow-up of penetrating ulcer and intramural hematoma of the aortaThe Journal of Thoracic and Cardiovascular Surgery, 2002