Morphologic predictors of aortic expansion in chronic type B aortic dissection.

Kotelis, D; Grebe, G; Kraus, P; Müller-Eschner, M; Bischoff, M; von Tengg-Kobligk, Hendrik; Böckler, D (2016). Morphologic predictors of aortic expansion in chronic type B aortic dissection. Vascular medicine, 24(2), pp. 187-193. Sage 10.1177/1708538115591941

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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 mm(2) vs. +37.5 mm(2); 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.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
UniBE Contributor:	von Tengg-Kobligk, Hendrik
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1358-863X
Publisher:	Sage
Language:	English
Submitter:	Aisha Stefania Mzinga
Date Deposited:	05 Apr 2016 13:15
Last Modified:	05 Dec 2022 14:52
Publisher DOI:	10.1177/1708538115591941
PubMed ID:	26079830
Uncontrolled Keywords:	Morphologic predictors; aortic expansion; chronic type B aortic dissection
URI:	https://boris.unibe.ch/id/eprint/77154