Partial thrombosis of the false lumen in patients with acute type B aortic dissection.

Published

Journal Article

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 proportional-hazards 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.

Full Text

Duke Authors

Cited Authors

  • Tsai, TT; Evangelista, A; Nienaber, CA; Myrmel, T; Meinhardt, G; Cooper, JV; Smith, DE; Suzuki, T; Fattori, R; Llovet, A; Froehlich, J; Hutchison, S; Distante, A; Sundt, T; Beckman, J; Januzzi, JL; Isselbacher, EM; Eagle, KA; International Registry of Acute Aortic Dissection,

Published Date

  • July 26, 2007

Published In

Volume / Issue

  • 357 / 4

Start / End Page

  • 349 - 359

PubMed ID

  • 17652650

Pubmed Central ID

  • 17652650

Electronic International Standard Serial Number (EISSN)

  • 1533-4406

Digital Object Identifier (DOI)

  • 10.1056/NEJMoa063232

Language

  • eng

Conference Location

  • United States