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A study of aortic dimension in type B aortic dissection.
Shang Dong Xu1, Fang Jiong Huang, Jia Hui Du
1Cardiac Surgery Division, Beijing Institute of Heart, Lung and Vascular Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. xushangdong@vip.sina.com
Interactive Cardiovascular and Thoracic Surgery
|January 12, 2008
Summary
Type B aortic dissection shows significant aortic tapering from the arch to the descending aorta's true lumen. This finding suggests tapered stent-grafts may improve endovascular repair outcomes.
Area of Science:
- Cardiovascular Surgery
- Medical Imaging
- Vascular Biology
Background:
- Type B aortic dissection (TBAD) involves a tear in the descending aorta.
- Accurate measurement of aortic dimensions is crucial for effective endovascular repair.
- The aortic taper ratio, the difference between arch and descending aorta diameters, is a key metric.
Purpose of the Study:
- To investigate the aortic taper ratio in patients with acute and chronic Type B aortic dissection.
- To compare aortic taper in TBAD patients with healthy controls.
- To evaluate the potential of tapered stent-grafts for TBAD treatment.
Main Methods:
- Retrospective analysis of 42 patients with TBAD undergoing endovascular repair (23 acute, 19 chronic) and 20 healthy controls.
- Measurements of aortic arch (Proximal) and mid-descending aorta true lumen (Distal) diameters using CT angiography (CTA) and digital subtraction angiography (DSA).
- Calculation of the taper ratio: (Proximal - Distal) / Proximal x 100%.
Main Results:
- Healthy controls exhibited a mean taper ratio of 13.0% ± 4.7% on CTA.
- Acute TBAD patients showed significantly higher taper ratios: 23.6% ± 11.3% (DSA) and 21.9% ± 12.1% (CTA).
- Chronic TBAD patients demonstrated even greater tapering: 31.5% ± 13.6% (DSA) and 30.1% ± 11.4% (CTA).
Conclusions:
- The descending aorta exhibits significant tapering from the arch in both acute and chronic Type B aortic dissection.
- A tapered aortic shape in TBAD suggests that stent-grafts with a tapered design could be beneficial for endovascular repair.
- Further research into tapered stent-graft designs is warranted for optimizing TBAD treatment.
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