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Prevalence of the Computed Tomographic Morphological DISSECT Predictors in Uncomplicated Stanford Type B Aortic

Marius Ante1, Spyridon Mylonas2, Denis Skrypnik1

  • 1Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Heidelberg, Germany.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|July 31, 2018
PubMed

Insights

Computed tomographic (CT) morphological predictors are common in acute Stanford type B aortic dissection (ATBAD) and correlate with aortic diameter expansion. These CT findings help identify patients at risk for disease progression.

Area of Science:

  • Cardiovascular Imaging
  • Thoracic Surgery
  • Radiology

Background:

  • Acute Stanford type B aortic dissection (ATBAD) requires monitoring for disease progression.
  • Morphological predictors on computed tomography (CT) may indicate risk for aortic diameter expansion.

Purpose of the Study:

  • To analyze the prevalence of CT morphological predictors in uncomplicated ATBAD.
  • To determine the influence of these predictors on early aortic diameter expansion.

Main Methods:

  • Retrospective analysis of CT imaging in 140 patients with uncomplicated ATBAD.
  • Assessment of baseline CT predictors including primary entry tear (PET) characteristics, maximum aortic diameter, false lumen (FL) diameter, FL thrombosis, and fusiform index (FI).
  • Evaluation of thoracic aortic diameter expansion (ADE) in 65 patients on best medical therapy (BMT) over a median follow-up of 11.6 months.

Main Results:

  • A mean of 2.45 predictors per patient were identified; 75% had at least two predictors.
  • Prevalence rates included: PET at arch concavity (18.6%), PET diameter ≥10 mm (60.0%), descending aortic diameter ≥40 mm (51.4%), FL diameter ≥22 mm (47.9%), partial FL thrombosis (47.9%), and FI ≥0.64 (20.7%).
  • Aortic diameter expansion (ADE) ≥5 mm was observed in 38 of 65 patients (58.5%), with a median ADE of 5.1 mm. Each predictor added an average of 1.9 mm to ADE.

Conclusions:

  • Most patients with uncomplicated ATBAD exhibit at least one CT morphological predictor.
  • CT-based predictors are associated with aortic diameter expansion, aiding in risk stratification for ATBAD patients.
  • These findings support the use of CT imaging to identify patients requiring closer monitoring for disease progression.
Abstract

Keywords:
Aortic dissectionCT morphological predictors in uncomplicated type B aortic disease

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