Document Detail


Impact of new development of ulcer-like projection on clinical outcomes in patients with type B aortic dissection with closed and thrombosed false lumen.
MedLine Citation:
PMID:  20837929     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to investigate the clinical importance of newly developed ulcer-like projection (ULP) in patients with type B aortic dissection with closed and thrombosed false lumen (AD with CTFL), which is better known as aortic intramural hematoma. METHODS AND RESULTS: A total of 170 patients with acute type B AD with CTFL were admitted to our institution from 1986 to 2008 and treated initially with medical therapy. There were 31 late deaths, including 9 cases of aortic rupture. The actuarial survival rates of all patients were 99%, 89%, 83% at 1, 5, and 10 years, respectively. A total of 62 (36%) patients showed new ULP development within 30 days from the onset. Patients who had ULP showed significantly poorer survival rates than patients who did not have ULP (P=0.037). Development of ULP was also associated with a significant increase in adverse aorta-related events (P<0.001). In addition, patients with ULP in the proximal descending thoracic aorta (PD) showed significantly higher aorta-related event rates than patients without ULP in the PD (P<0.001). Initial aortic diameter (hazard ratio, 3.55; P<0.001) and development of ULP in PD (hazard ratio, 3.79; P=0.003) were the strongest predictors of adverse aorta-related events. CONCLUSIONS: Initial aortic diameter and development of ULP in the PD are both strong predictors of adverse aorta-related events in patients with type B AD with CTFL. Patients with newly developed ULP should be more carefully followed up with close surveillance imaging than those without ULP.
Authors:
Takeshi Kitai; Shuichiro Kaji; Atsushi Yamamuro; Tomoko Tani; Makoto Kinoshita; Natsuhiko Ehara; Atsushi Kobori; Toru Kita; Yutaka Furukawa
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  122     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-14     Completed Date:  2010-10-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S74-80     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Chuo-ku, Kobe, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aortic Rupture* / mortality,  pathology
Disease-Free Survival
Female
Hematoma* / mortality,  pathology
Humans
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Risk Factors
Survival Rate
Thrombosis* / mortality,  pathology
Ulcer* / mortality,  pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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