title: Fate of aorta and clinical outcomes in patients with chronic type B aortic dissection: over 20-year experience.
abstract: OBJECTIVE
  In type B double-barrel aortic dissection (AD), the fate of the affected aorta, causes of death, and very long-term clinical outcomes have not been completely elucidated. The purpose of this study was to clarify the fate of the affected aorta and long-term clinical outcomes in patients with type B AD during the chronic phase.
  
  
  METHODS
  One hundred and four patients were entered into this study, and regular follow-up CT studies (mean; 87.6 months) were performed. Also, clinical data including AD-related events (including aneurysm formation, rupture, ischemia, and re-dissection), AD-related deaths, and long-term survival were retrospectively reviewed.
  
  
  RESULTS
  Forty-six of 104 patients (44.2%) had one more AD-related event during the follow-up period. The actuarial event-free rates for any AD-related events of all patients were 95±2%, 75±5%, 53±6%, and 13±7% at 1, 5, 10, and 20 years, respectively. Initial aortic diameter ≥40 mm and blood flow in the false lumen were significant risk factors for AD-related events in univariate and multivariate analysis.
  
  
  CONCLUSIONS
  In type B chronic aortic dissection, the affected aortas have a high incidence of AD-related events during the follow-up period. Prophylactic surgery or endovascular treatment for patients at high risk may reduce the AD-related events.
authors.affiliation: Department of Radiology, Nagasaki University School of Medicine, Nagasaki, Japan - sueyo@nagasaki-u.ac.jp.
authors.forename: E
authors.initials: E
authors.lastname: Sueyoshi
authors.forename: H
authors.initials: H
authors.lastname: Nagayama
authors.forename: T
authors.initials: T
authors.lastname: Hayashida
authors.forename: I
authors.initials: I
authors.lastname: Sakamoto
authors.forename: M
authors.initials: M
authors.lastname: Uetani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D001027:Aortography / Q000379:methods*; D016009:Chi-Square Distribution; D002908:Chronic Disease; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures