Treatment patterns and their outcomes of acute aortic intramural hematoma in real world: multicenter registry for aortic intramural hematoma

Title
Treatment patterns and their outcomes of acute aortic intramural hematoma in real world: multicenter registry for aortic intramural hematoma
Author(s)
박종선최윤정[최윤정]손장원이상희김웅신동구김영조허승호[허승호]남창욱[남창욱]조윤경[조윤경]이봉렬[이봉렬]정병천[정병천]류재근[류재근]이진배[이진배]박헌식[박헌식]이장훈[이장훈]장세영[장세영]
Keywords
DESCENDING THORACIC AORTA; LONG-TERM PROGNOSIS; COMPUTED-TOMOGRAPHY; CLINICAL-OUTCOMES; DISSECTION; HEMORRHAGE; CT; PROGRESSION; MANAGEMENT; RUPTURE
Issue Date
201409
Publisher
BIOMED CENTRAL LTD
Citation
BMC CARDIOVASCULAR DISORDERS, v.14
Abstract
Background: Intramural hematoma of the aorta (IMH), a variant of classic aortic dissection, shows very dynamic process in the early phase. The aim of this study is to evaluate clinical outcomes of patients with acute aortic IMH from real world registry data. Methods: We analyzed 165 consecutive patients with acute IMH from five medical centers in Korea. All patients were divided into two groups; type A (n = 61, 37.0%) and type B (n = 104, 63.0%) according to the Stanford classification. Clinical outcomes and morphological evolution by CT were analyzed for 2 years. Results: Most of the patients (77.0% of type A and 99.0% of type B, P < 0.001) were treated medically during their initial hospitalization. There were no significant differences in in-hospital mortality (4.9% vs. 2.9%, P = 0.671) and 2-year mortality (13.1% vs. 11.5%, P = 0.765) between two groups. During the 2-year follow up period, progression to aortic dissection (18.0% vs. 6.7%, P = 0.037) and surgical treatment (29.5% vs. 2.9%, P < 0.001) were higher in type A. For the type A patients, there were no significant difference in in-hospital mortality (7.1% of surgery vs. 4.3% of medical, P = 0.428) and 2-year mortality (7.1% of surgery vs. 14.9% of medical, P = 0.450) in terms of initial treatment strategy. Conclusion: For real world practice in Korea, most of IMH patients were treated medically at presentation and showed favorable outcomes. Thus, even in type A acute IMH, early medical treatment with alternative surgical conversion for selected, complicated cases would be a favorable treatment option.
URI
http://hdl.handle.net/YU.REPOSITORY/30924http://dx.doi.org/10.1186/1471-2261-14-103
ISSN
1471-2261
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의과대학 > 내과학교실 > Articles
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