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CTA Imaging Features Related to Preoperative Coagulopathy in Patients with Stanford Type A Acute Aortic Dissection

Yu Li1, Mingming Zhao2, Jiaqi Tong3

  • 1Department of Radiology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China; Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Annals of Vascular Surgery
|December 21, 2021
PubMed

Insights

Stanford type A acute aortic dissection (TAAAD) patients with preoperative coagulopathy showed increased white blood cell count, longer dissection length, and higher tear index. These factors are crucial for predicting coagulopathy in TAAAD.

Area of Science:

  • Cardiovascular Surgery
  • Radiology
  • Hematology

Background:

  • Stanford type A acute aortic dissection (TAAAD) frequently presents with preoperative coagulation disorders.
  • Understanding the link between imaging features and coagulopathy is vital for TAAAD management.

Purpose of the Study:

  • To investigate the association between computed tomography angiography (CTA) imaging characteristics and preoperative coagulopathy in TAAAD patients.
  • To identify imaging predictors of coagulopathy in the TAAAD population.

Main Methods:

  • Retrospective analysis of 174 adult TAAAD patients from Beijing Anzhen Hospital (2015-2019).
  • Preoperative CTA imaging and disseminated intravascular coagulation (DIC) scores were assessed.
  • Tear index (TI) was calculated using false lumen (Fx) and true lumen (Tx) measurements across four aortic planes.

Main Results:

  • The incidence of preoperative coagulopathy in TAAAD patients was 12.07%.
  • Multivariate analysis identified elevated white blood cell count (OR: 1.204), longer aortic dissection length (OR: 1.076), and higher Tear Index (OR: 1.177) as significant predictors of coagulopathy.
  • These factors were significantly associated with the occurrence of preoperative coagulopathy (P < 0.016).

Conclusions:

  • White blood cell count, aortic dissection length, and Tear Index are significant factors associated with preoperative coagulopathy in TAAAD.
  • CTA imaging features, including TI, offer valuable insights into coagulopathy risk in TAAAD.
  • Further research into imaging and anatomical changes related to coagulopathy in TAAAD is warranted.
Abstract

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