Long-Term Outcome and Prognostic Predictors of Medically Treated Acute Type B Aortic Dissections

Onitsuka, Seiji; Akashi, Hidetoshi; Tayama, Keiichiro; Okazaki, Teiji; Ishihara, Kenji; Hiromatsu, Shinichi; Aoyagi, Shigeaki

doi:10.1016/j.athoracsur.2004.02.031

Cited by 169 publications

(123 citation statements)

References 9 publications

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“…[3][4][5][6][7] Other studies also indicate that 13-32% of patients with acute type B aortic dissection require surgical treatment during follow-up. 5,6,13 Similarly, in the current study, dissection-related aortic events occurred in 18% of hospital survivors during an average of 2.4 years of follow-up. Such a high incidence of aortic events and necessity of surgical repair underscore the importance of optimizing the medical treatment for the chronic stage of type B aortic dissection.…”

Section: Discussionmentioning

confidence: 88%

Angiotensin-Converting Enzyme Inhibitors Reduce Long-Term Aortic Events in Patients With Acute Type B Aortic Dissection

Takeshita

Sakamoto

Kitada

et al. 2008

Circ J

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Background Medical therapy gives excellent short-term outcomes for patients with Stanford type B acute aortic dissection. However, the affected aorta is often compromised by aneurysmal dilatation and rupture, resulting in poor long-term outcome. The present study investigated which antihypertensive treatment may prevent longterm aortic events in these patients. Methods and ResultsThe study group comprised 78 consecutive patients with Stanford type B acute aortic dissection who were treated medically and followed-up for an average of 873±548 days. The optimal hypertensive drug regimen to reduce aortic events was determined by multivariate analyses. Of the 78 patients, 73 (94%) were discharged from hospital with medical therapy, and aortic events occurred in 13 (18%) of them (aortic rupture/recurrent dissection in 2 (3%); aortic expansion ≥60 mm in 7 (10%), rapid aortic expansion ≥10 mm/year in 3 (4%), and development of visceral/limb ischemia in 1 (1%)) during follow-up. By multivariate analysis, patients given angiotensin-converting enzyme inhibitor (ACEI) were less likely to have long-term aortic events than those without (odds ratio: 0.18, 95% confidence interval: 0.04-0.85). Conclusions Use of ACEI is associated with a reduced risk of long-term aortic events in patients with medically treated type B aortic dissection. (Circ J 2008; 72: 1758 -1761

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Section: Discussionmentioning

confidence: 88%

Angiotensin-Converting Enzyme Inhibitors Reduce Long-Term Aortic Events in Patients With Acute Type B Aortic Dissection

Takeshita

Sakamoto

Kitada

et al. 2008

Circ J

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“…These parameters are relatively simply derived from 2D CT. False lumen closure status is generally classified as 1 of 2 patterns (thrombosed and nonthrombosed) or 3 patterns (thrombosed, nonthrombosed, and partially thrombosed). 4,6,8,9 Maximum aortic diameter is calculated from 1 cross-sectional image. 4,6,8 However, the anatomy of the aortic dissection is often complex and is not necessarily consistent, even during the initial hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Peak C-Reactive Protein Level Predicts Long-Term Outcomes in Type B Acute Aortic Dissection

et al. 2010

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Abstract-Acute aortic dissection (AAD) is associated with an inflammatory reaction, as evidenced by elevated inflammatory markers, including C-reactive protein (CRP). The association between the peak CRP level and long-term outcomes in type B AAD has not been systematically investigated. The purpose of this study was to investigate whether the peak CRP level during admission predicts long-term outcomes in type B AAD. We conducted a clinical follow-up study of type B AAD. We divided the study population into 4 groups according to the tertiles of peak CRP levels (T1: 0.60 to 9.37 mg/dL; T2: 9.61 to 14.87 mg/dL; T3: 14.90 to 32.60 mg/dL; and unavailable peak CRP group). Multivariate Cox regression analysis was applied to investigate whether the tertiles of peak CRP predict adverse events even after adjusting for other variables. A total of 232 type B AAD patients were included in this analysis. The median follow-up period was 50 months. CRP reached its peak on day 4.5Ϯ1.7. Mean peak CRP values in T1, T2, and T3 were 6.4Ϯ2.

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“…A large aortic diameter is associated with increased rupture risk, and several authors have shown that an aortic diameter between 50 and 60 mm is associated with rupture in almost 20% of cases. 92,97,167,179 It should be acknowledged that there is a paucity of literature describing the aortic rupture risk in relation to aortic diameters in patients with CTBAD. 3.2.2.2.…”

Section: Recommenda On 32mentioning

confidence: 99%

Editor's Choice – Management of Descending Thoracic Aorta Diseases

Riambau¹,

Böckler²,

Brunkwall³

et al. 2017

European Journal of Vascular and Endovascular Surgery

948

259

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Long-Term Outcome and Prognostic Predictors of Medically Treated Acute Type B Aortic Dissections

Cited by 169 publications

References 9 publications

Angiotensin-Converting Enzyme Inhibitors Reduce Long-Term Aortic Events in Patients With Acute Type B Aortic Dissection

Angiotensin-Converting Enzyme Inhibitors Reduce Long-Term Aortic Events in Patients With Acute Type B Aortic Dissection

Peak C-Reactive Protein Level Predicts Long-Term Outcomes in Type B Acute Aortic Dissection

Editor's Choice – Management of Descending Thoracic Aorta Diseases

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