title: Long-term follow-up of acute type B aortic dissection: ulcer-like projections in thrombosed false lumen play a role in late aortic events.
abstract: OBJECTIVE
  Patients with Stanford type B dissection treated medically during the acute phase have a risk of surgery and aortic rupture during the chronic phase. We investigated the predictors for late aortic events by focusing on the false lumen status with computed tomography.
  
  
  METHODS
  A total of 160 patients were enrolled in the study, with a mean follow-up interval of 44.6 ± 25.4 months. Patients were divided into 3 groups according to the false lumen status at the time of onset: group T, thrombosed in 49 patients (30.6%); group U, thrombosed with ulcer-like projections in 52 patients (32.5%); and group P, patent in 59 patients (36.9%).
  
  
  RESULTS
  The mean aortic enlargement rate of groups U and P was greater than that of group T (0.40 ± 0.91 mm/month in group U, 0.44 ± 0.49 mm/month in group P, and -0.016 ± 0.23 mm/month in group T). The event-free rate in groups U and P was lower than in group T: 5-year event-free rates of 67.4% ± 8.2% in group U and 57.7% ± 10.9% in group P versus 95.0% ± 4.9% in group T (group T vs group U: P = .0011, group U vs group P: P = .96, group P vs group T: P = .0004). Cox regression analysis revealed that the false lumen status (patent or ulcer-like projections) (P = .029), maximum aortic diameter at onset (P < .0001), and patient age (P = .0069) were predictors of the late aortic events.
  
  
  CONCLUSIONS
  In type B aortic dissection, a thrombosed false lumen with ulcer-like projections and a patent false lumen had an influence on late aortic dilation and late aortic events.
authors: Division of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Hyogo, Japan. shunnsuke0530@hotmail.com
authors: Shunsuke
authors: S
authors: Miyahara
authors: Nobuhiko
authors: N
authors: Mukohara
authors: Masaomi
authors: M
authors: Fukuzumi
authors: Naoto
authors: N
authors: Morimoto
authors: Hirohisa
authors: H
authors: Murakami
authors: Keitaro
authors: K
authors: Nakagiri
authors: Masato
authors: M
authors: Yoshida
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging*; D001014:Aortic Aneurysm / Q000150:complications / Q000000981:diagnostic imaging*; D001018:Aortic Diseases / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012044:Regression Analysis; D012307:Risk Factors; D013927:Thrombosis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014456:Ulcer