Artikel ; Online: Radiographic complicated and uncomplicated descending aortic dissections: aortic morphological differences by CT angiography and risk factor analysis.
European heart journal. Cardiovascular Imaging
2024 Band 25, Heft 6, Seite(n) 867–877
Abstract: Aims: To identify radiographic differences between patients with uncomplicated and complicated descending aortic dissections.: Methods and results: Between April 2009 and July 2021, 209 patients with acute descending aortic dissections were analysed ... ...
Abstract | Aims: To identify radiographic differences between patients with uncomplicated and complicated descending aortic dissections. Methods and results: Between April 2009 and July 2021, 209 patients with acute descending aortic dissections were analysed as complicated (malperfusion, rupture, diameter progress, and diameter ≥ 55 mm) or uncomplicated. Detailed CTA measurements (slice thickness ≤ 3 mm) were taken in multiplanar reconstruction. A composite endpoint (early aortic failure) was defined as reoperation, diameter progression, and early mortality. 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, 14.0 mm [12.0 mm; 27.0 mm] vs. 6.0 mm [4,0 mm; 13.0 mm] 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 > 19.38 mm [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)]. Conclusion: 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. |
---|---|
Mesh-Begriff(e) | Humans ; Female ; Aortic Dissection/diagnostic imaging ; Aortic Dissection/surgery ; Male ; Aortic Aneurysm, Thoracic/diagnostic imaging ; Aortic Aneurysm, Thoracic/surgery ; Computed Tomography Angiography/methods ; Middle Aged ; Aged ; Risk Factors ; Retrospective Studies ; Aorta, Thoracic/diagnostic imaging ; Risk Assessment |
Sprache | Englisch |
Erscheinungsdatum | 2024-01-10 |
Erscheinungsland | England |
Dokumenttyp | Journal Article ; Comparative Study |
ZDB-ID | 2638345-7 |
ISSN | 2047-2412 ; 2047-2404 |
ISSN (online) | 2047-2412 |
ISSN | 2047-2404 |
DOI | 10.1093/ehjci/jeae030 |
Datenquelle | MEDical Literature Analysis and Retrieval System OnLINE |
Zusatzmaterialien
Kategorien
Verfügbar in ZB MED Köln/Königswinter
Zs.A 5614: Hefte anzeigen | Standort: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG) |
Über subito bestellen
Dieser Service ist kostenpflichtig (siehe Lieferbedingungen von subito). Bestellungen, die einen Artikel nebst Supplementary Material umfassen, werden grundsätzlich wie mehrfache Bestellungen bearbeitet. Gebühren fallen in diesen Fällen für jede einzelne Bestellung an.