Growth Rate of Aortic Diameter in Post Treatment of Aortic Dissection

To evaluate growth rate of aortic diameter true lumen, and false lumen in post endovascular aortic repair of aortic dissection.

Between January 2005 and September 2010, 48 consecutive patients with aortic dissection were followed with computed tomographic angiography (CTA), including 18 post-surgical repaired type A patients and 30 type B (14 conservative treatment and 16 post stent-grafting therapy). CTA were performed with a mean of 5.2 scans per patient, and a meanfollow-up of 37.08 months. The diameter ofthe aorta, true lumen, andfalse lumen were measured by axial scan images and multi-planar reformatting (MPR).

In medically managed patients with type B aortic dissection, the aortic diameter increased over time at mean rate 1.49 mm/year at proximal descending aorta with greater increased in size ofthe false lumen diameters than the true lumen diameter. In post-surgical repaired type A and post stent-grafting therapy type B aortic dissection, aortic diameter did not change over time. In addition, 12 of 16 patients (75%)patients with post stent-grafting therapy type B dissection hadpartial thrombosed in false lumen and 4 of 16 patients (25%) had complete resolution offalse lumen.

In post-surgical repaired type A and post stent-grafting therapy type B aortic dissection, aortic diameter did not change over time. Type B aortic dissection with medical treatment had minimal increased in aortic diameter over time. The results suggested that uncomplicated type B aortic dissection requires on-going medical treatment.