| Impact of new development of ulcer-like projection on clinical outcomes in patients with type B aortic dissection with closed and thrombosed false lumen. | |
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MedLine Citation:
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PMID: 20837929 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Takeshi Kitai; Shuichiro Kaji; Atsushi Yamamuro; Tomoko Tani; Makoto Kinoshita; Natsuhiko Ehara; Atsushi Kobori; Toru Kita; Yutaka Furukawa |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Circulation Volume: 122 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-14 Completed Date: 2010-10-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: S74-80 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Chuo-ku, Kobe, Japan. |
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| MeSH Terms | |
Descriptor/Qualifier:
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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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