Comparison of Outcome in Aortic Dissection with Single False Lumen versus Multiple False Lumens: CT Assessment

Abstract

Multibarreled AD occurs in 9% of acute type B dissections. The presence of multibarreled AD is a powerful predictor of AD-related deaths.

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

“…Different publications highlight the association of this predictor with late aortic events. 9,12,14,22,27,28 . One may speculate that a larger initial aortic diameter will lead to an accelerated ADE over time.…”

Type B Aortic Dissection: A Review of Prognostic Factors and Meta-analysis of Treatment Options

“…The highest growth rates were seen in patients with a single entry tear located within 5 cm of the left subclavian artery. Sueyoshi et al [65] showed that the presence of multiple false lumens was an independent predictor of dissectionrelated death (HR 5.6) compared to patients with conventional dissection consisting of one true and one false lumen (18% versus 82% survival at 10 years, respectively). Additionally, Evangelista et al [43] demonstrated that patients with an entry tear of Ն 10 mm had a higher incidence of dissection-related complications (HR 5.8) and a higher median growth rate than those with an entry tear measuring Ͻ 10 mm.…”

Outcomes of thoracic endovascular repair for type B aortic dissection with multichanneled morphology

“…So far, most descriptions of MCAD have been limited to isolated case reports 5,[13][14][15] or studies evaluating poor outcomes and complications by open surgery and endovascular treatment. 6,7 According to previous studies, the incidence of MCAD varied from 4.9% to 9%. [5][6][7][13][14][15] We observed dissections with more than two adjacent FLs in 54 (8.4%) of 644 patients treated with TEVAR.…”

“…6,7 According to previous studies, the incidence of MCAD varied from 4.9% to 9%. [5][6][7][13][14][15] We observed dissections with more than two adjacent FLs in 54 (8.4%) of 644 patients treated with TEVAR. This incidence was similar to that in previous reports, suggesting that the condition may occur frequently and is of great concern.…”

“…However, multichanneled AD (MCAD) is considered a relatively rare condition and was first reported in 1978 by McReynolds et al 5 Previous studies suggested that the presence of MCAD is a powerful predictor of AD-related deaths after open surgery or TEVAR. 6,7 The elevated pressure in different false lumens (FLs) for patients with MCAD results in complex communications to the true lumen (TL), which may cause these patients to be at a higher risk for TL collapse, aneurysm, and rupture. Treatment for TL collapse involves decreasing the flow of blood into the FL and increasing the flow from it.…”