Lower circulating Sta-Liatest D-Di levels in patients with aortic intramural hematoma compared with classical aortic dissection.
OBJECTIVE
To compare the diagnostic value of circulating Sta-Liatest D-Di levels in classic acute aortic dissection (AAD) and in aortic intramural hematoma (AIH), a variant of AAD without a patent false lumen.


METHODS
Single-center retrospective case-control study.


METHODS
University Hospital of Strasbourg, France.


METHODS
Ninety-four consecutive patients with both confirmed AAD and d-dimer measurements at entry were included. d-dimer levels were assayed by the immunoturbidimetric method Sta-Liatest D-Di (Diagnostica Stago, Asnieres sur Seine, France).


METHODS
Patient characteristics and clinical evolution were analyzed.


RESULTS
Eighty-four patients (89%) presented a classic AAD with patent false lumen and ten (11%) presented an AIH. Clinical presentation did not differ between the two groups. The mortality rate was 0% in AIH and 26% in classic AAD. d-dimer levels were significantly lower in patients with AIH (median, 1230 ng/mL; interquartile range, 685-2645 ng/mL) than in patients with AAD with patent false lumen (median value, 9290 ng/mL; interquartile range, 3890-20,000 ng/mL; p = 0.008). All patients with AAD and patent false lumen had d-dimer levels above the threshold of 400 ng/mL (sensitivity 100%). However, one patient with AIH presented d-dimer levels below the threshold. Therefore, the sensitivity of the d-dimer test in detecting AIH was 90%.


CONCLUSIONS
Sta-Liatest D-Di levels are lower in AIH than in AAD with patent false lumen. This test can quite possibly be negative in the case of intramural hematoma. This feature must be considered when interpreting d-dimer levels in patients with acute aortic syndrome.
Ohlmann
Patrick
P
Departments of Cardiac Surgery, University Hospital of Strasbourg, France. patrick.ohlmann@chru-strasbourg.fr
Faure
Antoine
A
Morel
Olivier
O
Kindo
Michel
M
Jesel
Laurence
L
Radulescu
Bogdan
B
Billaud
Philippe
P
Meyer
Nicolas
N
Petit
Hélène
H
Trinh
Annie
A
Epailly
Eric
E
Roul
Gérald
G
Chauvin
Michel
M
Mazzucotelli
Jean-Philippe
JP
Eisenmann
Bernard
B
Bareiss
Pierre
P
D000208:Acute Disease; D000368:Aged; D001018:Aortic Diseases / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006406:Hematoma / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D