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Comparison of outcome in aortic dissection with single false lumen versus multiple false lumens: CT assessment

Eijun Sueyoshi1, Hiroki Nagayama, Takeshi Hayashida

  • 1Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.

Radiology
|January 9, 2013
PubMed

Insights

Multibarreled aortic dissection (AD) occurs in 9% of type B cases and significantly increases the risk of death. This finding highlights multibarreled AD as a critical predictor of mortality in patients with this condition.

Area of Science:

  • Cardiovascular Imaging
  • Thoracic Surgery
  • Vascular Medicine

Background:

  • Aortic dissection (AD) is a life-threatening condition involving a tear in the aorta's inner layer.
  • Type B AD typically involves the descending aorta and can present with varying anatomical complexities.
  • Distinguishing between different AD morphologies is crucial for predicting patient outcomes.

Purpose of the Study:

  • To compare the clinical features and outcomes of multibarreled (multiple false lumens) type B aortic dissection (AD) versus double-barreled (single false lumen) AD.
  • To evaluate the prognostic significance of multibarreled AD using computed tomography (CT) imaging.

Main Methods:

  • Retrospective analysis of 221 consecutive patients with acute type B AD.
  • CT imaging was used to identify and classify AD morphology (double-barreled vs. multibarreled).
  • Clinical outcomes, including AD-related events, deaths, and long-term survival (up to 10 years), were assessed using Kaplan-Meier and Cox proportional hazards models.

Main Results:

  • Multibarreled AD was identified in 9% of patients (20/221), with 75% experiencing AD-related events and 45% dying from complications.
  • Patients with multibarreled AD had significantly poorer survival rates compared to those with double-barreled AD (P = .0002).
  • Multivariate analysis identified multibarreled false lumen as the strongest risk factor for AD-related death (HR, 5.61; P < .0001).

Conclusions:

  • Multibarreled AD is present in approximately 9% of acute type B dissections.
  • The presence of a multibarreled false lumen is a powerful independent predictor of mortality in type B aortic dissection.
Abstract

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