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Aortic Calcification Severity Predicts Unfavorable Anatomy and Adverse Outcomes in Type B Aortic Dissection

Long Cao1,2, Zelin Niu1, Longteng Ma3

  • 1Department of Vascular and Endovascular Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|April 20, 2026
PubMed

Insights

Aortic calcification severity, especially in the thoracic aorta, is linked to unfavorable anatomy in type B aortic dissection (TBAD). Increased calcification volume predicts higher risks of adverse events and aortic expansion after thoracic endovascular aortic repair (TEVAR).

Area of Science:

  • Cardiovascular Imaging and Intervention
  • Aortic Disease Research
  • Biomarker Discovery in Cardiovascular Medicine

Background:

  • Aortic calcification (AC) is a known cardiovascular disease marker, but its specific role in acute aortic syndromes like type B aortic dissection (TBAD) remains unclear.
  • Understanding AC distribution and its prognostic implications in TBAD is crucial for patient management.

Purpose of the Study:

  • To characterize AC distribution in TBAD patients.
  • To examine the association between AC volume and initial aortic anatomy in TBAD.
  • To assess the prognostic value of AC volume for outcomes after thoracic endovascular aortic repair (TEVAR).

Main Methods:

  • Retrospective analysis of 270 patients (150 from a single center, 120 from a clinical trial) with TBAD.
  • Cross-sectional evaluation of preoperative AC volume in different aortic segments and its correlation with initial TBAD anatomy.
  • Survival analysis and multivariable Cox regression to assess the 1-year prognostic value of AC volume post-TEVAR.

Main Results:

  • AC volume correlated with unfavorable preoperative TBAD anatomy, including increased aortic size and tortuosity.
  • Thoracic aorta AC volume was a significant predictor of composite events post-TEVAR (HR 2.396), thoracic aorta expansion (HR 6.266), and abdominal aorta expansion (HR 2.569).

Conclusions:

  • Aortic calcification severity, particularly in the thoracic aorta, is associated with unfavorable anatomical features in TBAD.
  • AC volume independently predicts the risk of subsequent aortic expansion and adverse events following TEVAR.
  • AC volume serves as a potential imaging biomarker for risk stratification in TBAD patients undergoing TEVAR.
Abstract

Keywords:
aortic calcificationcomputed tomographyprognostic valuethoracic endovascular aortic repairtype B aortic dissection

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