Article ; Online: Radiographic complicated and uncomplicated descending aortic dissections: aortic morphological differences by CT angiography and risk factor analysis.
European heart journal. Cardiovascular Imaging
2024
Abstract: Objective: To identify radiographic differences between patients with uncomplicated and complicated descending aortic dissections.: Methods: Between 04/2009 and 07/2021, 209 patients with acute descending aortic dissections were analyzed as ... ...
Abstract | Objective: To identify radiographic differences between patients with uncomplicated and complicated descending aortic dissections. Methods: Between 04/2009 and 07/2021, 209 patients with acute descending aortic dissections were analyzed as complicated (malperfusion, rupture, diameter progress, and diameter ≥55mm) or uncomplicated. Detailed CTA measurements (slice thickness ≤ 3mm) were taken in multiplanar reconstruction. A composite endpoint (early aortic failure) was defined as reoperation, diameter progression, and early mortality. Results: Seventy-seven patients were female (36.8%) (complicated n=27 (36.5%); uncomplicated n=50 (37.0%) p=1.00). Seventy-four (35%) patients were categorized as morphologically complicated, and 135 (65%) as uncomplicated. In patients with complicated dissections, the dissection extended more frequently to the aortic bifurcation (p=0.044), the coeliac trunk (p=0.003), the superior mesenteric artery (p=0.007), and both iliac arteries (p<0.001) originated less frequently from the true lumen. The length of the most proximal communication (entry) in type B aortic dissection was longer, 14.0mm [12.0mm; 27.0mm] vs 6.0mm [4,0mm; 13.0mm] in complicated cases (p=0.005). Identified risk factors for adverse aortic events were connective tissue disease (HR 8.0 (1.9 - 33.7 95%CI HR)) length of the aortic arch (HR 4.7 (1.5 - 15.1 95%CI HR)) a false lumen diameter >19.38mm (HR 3.389 (1.1-10.2 95%CI HR) and origin of the inferior mesenteric artery from the false lumen (HR 4.2 (1.0 - 5.5 95%CI HR)). Conclusions: We identified significant morphological differences and predictors for adverse events in patients presenting complicated and uncomplicated descending dissections. Our morphological findings will help guide future aortic therapies, taking a tailored patient approach. |
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Language | English |
Publishing date | 2024-01-25 |
Publishing country | England |
Document type | Journal Article |
ZDB-ID | 2638345-7 |
ISSN | 2047-2412 ; 2047-2404 |
ISSN (online) | 2047-2412 |
ISSN | 2047-2404 |
DOI | 10.1093/ehjci/jeae030 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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