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Aortic diameter, true lumen, and false lumen growth rates in chronic type B aortic dissection

Kevin J Blount1, Klaus D Hagspiel

  • 1Department of Radiology, University of Virginia, 1000 Lee Street, Charlottesville, VA 22908, USA. kjb6c@virginia.edu

AJR. American Journal of Roentgenology
|April 22, 2009
PubMed

Insights

The aorta and its false lumen grow significantly over time in patients with chronic type B aortic dissection. Rapid aortic growth indicates a higher likelihood of needing surgical repair.

Area of Science:

  • Cardiovascular Medicine
  • Radiology
  • Vascular Surgery

Background:

  • Type B aortic dissection (TBAD) is a serious condition affecting the aorta.
  • Understanding the long-term aortic growth dynamics in medically managed TBAD is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the growth rates of the aorta, true lumen, and false lumen in patients with chronic type B aortic dissections.
  • To identify factors associated with aortic growth and the need for intervention.

Main Methods:

  • Serial MDCT angiography and MR angiography scans were used to follow 19 patients with acute type B aortic dissection over a mean of 17.9 months.
  • Aortic and lumen dimensions were measured using 3D workstations.
  • Linear regression analyses assessed growth rates.

Main Results:

  • Maximum aortic diameter increased significantly (7.1 mm/y), driven by false lumen expansion (diameter 6.5 mm/y, area 5.35 cm²/y).
  • True lumen also showed significant growth (diameter 0.79 mm/y, area 0.13 cm²/y).
  • Patients requiring aortic repair or experiencing death had a significantly higher aortic diameter growth rate (15.4 mm/y) compared to those not intervened upon (1.8 mm/y).

Conclusions:

  • The maximum aortic diameter in type B dissections increases significantly over time, primarily due to false lumen enlargement.
  • High aortic diameter growth rates are predictive of the need for future endovascular or open surgical aortic repair.
Abstract

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