Background Patency or thrombosis of the false lumen in type B acute aortic dissection has been found to predict outcomes. The prognostic implications of partial thrombosis of the false lumen have not yet been elucidated. Methods We examined 201 patients with type B acute aortic dissection who were enrolled in the International Registry of Acute Aortic Dissection between 1996 and 2003 and who survived to hospital discharge. Kaplan-Meier mortality curves were stratified according to the status of the false lumen (patent, partial thrombosis, or complete thrombosis) as determined during the index hospitalization. Cox proportionalhazards analysis was performed to identify independent predictors of death. Results During the index hospitalization, 114 patients (56.7%) had a patent false lumen, 68 patients (33.8%) had partial thrombosis of the false lumen, and 19 (9.5%) had complete thrombosis of the false lumen. The mean (±SD) 3-year mortality rate for patients with a patent false lumen was 13.7±7.1%, for those with partial thrombosis was 31.6±12.4%, and for those with complete thrombosis was 22.6±22.6% (median follow-up, 2.8 years; P = 0.003 by the log-rank test). Independent predictors of postdischarge mortality were partial thrombosis of the false lumen (relative risk, 2.69; 95% confidence interval [CI], 1.45 to 4.98; P = 0.002), a history of aortic aneurysm (relative risk, 2.05; 95% CI, 1.07 to 3.93; P = 0.03), and a history of atherosclerosis (relative risk, 1.87; 95% CI, 1.01 to 3.47; P = 0.05). Conclusions Mortality is high after discharge from the hospital among patients with type B acute aortic dissection. Partial thrombosis of the false lumen, as compared with complete patency, is a significant independent predictor of postdischarge mortality in these patients.
Acute Aortic Dissection. Partial thrombosis of the false lumen in patients with acute type B aortic dissection
2007
Abstract
Background Patency or thrombosis of the false lumen in type B acute aortic dissection has been found to predict outcomes. The prognostic implications of partial thrombosis of the false lumen have not yet been elucidated. Methods We examined 201 patients with type B acute aortic dissection who were enrolled in the International Registry of Acute Aortic Dissection between 1996 and 2003 and who survived to hospital discharge. Kaplan-Meier mortality curves were stratified according to the status of the false lumen (patent, partial thrombosis, or complete thrombosis) as determined during the index hospitalization. Cox proportionalhazards analysis was performed to identify independent predictors of death. Results During the index hospitalization, 114 patients (56.7%) had a patent false lumen, 68 patients (33.8%) had partial thrombosis of the false lumen, and 19 (9.5%) had complete thrombosis of the false lumen. The mean (±SD) 3-year mortality rate for patients with a patent false lumen was 13.7±7.1%, for those with partial thrombosis was 31.6±12.4%, and for those with complete thrombosis was 22.6±22.6% (median follow-up, 2.8 years; P = 0.003 by the log-rank test). Independent predictors of postdischarge mortality were partial thrombosis of the false lumen (relative risk, 2.69; 95% confidence interval [CI], 1.45 to 4.98; P = 0.002), a history of aortic aneurysm (relative risk, 2.05; 95% CI, 1.07 to 3.93; P = 0.03), and a history of atherosclerosis (relative risk, 1.87; 95% CI, 1.01 to 3.47; P = 0.05). Conclusions Mortality is high after discharge from the hospital among patients with type B acute aortic dissection. Partial thrombosis of the false lumen, as compared with complete patency, is a significant independent predictor of postdischarge mortality in these patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
