[Thrombosed type aortic dissection showing changes in the false lumen to the patent type]

Area of Science:

• Cardiology
• Radiology
• Vascular Surgery

Background:

• Acute aortic dissection (AAD) is a life-threatening condition.
• Thrombosed false lumens in AAD are often associated with a favorable prognosis.
• The dynamic nature of false lumen patency in AAD requires further investigation.

Purpose of the Study:

• To investigate the changes in false lumen patency in patients with acute aortic dissection and initially thrombosed false lumens.
• To identify the frequency and characteristics of thrombosed false lumens converting to patent false lumens.

Main Methods:

• Retrospective review of 34 patients with acute aortic dissection and thrombosed false lumens.
• Contrast-enhanced computed tomography (CT) scans performed between day 2 and day 19 post-onset.
• Analysis of false lumen changes, entry site location, and clinical presentation.

Main Results:

• In 12% of cases (4 out of 34), thrombosed false lumens became patent.
• Changes were detected on CT scans with a mean of 12.5 days after onset.
• Entry sites were primarily in the descending aorta, with some associated with ulcer-like projections.
• Most patients were asymptomatic during the transition, though one reported back pain.
• Two patients died from false lumen rupture during follow-up.

Conclusions:

• Thrombosed false lumens in acute aortic dissection can transition to a patent state, often asymptomatically.
• Radiologists must recognize the potential instability of thrombosed false lumens.
• Weekly follow-up CT scans for three weeks are recommended after the onset of dissection to monitor for these changes.