title: Importance of false lumen thrombosis in type B aortic dissection prognosis.
abstract: BACKGROUND
  Partial thrombosis of the false lumen has been reported as a significant predictor of mortality during follow-up in patients with acute type B aortic dissection. The purpose of this study was to investigate the correlation of false lumen thrombosis and aortic expansion during follow-up in patients with acute type B aortic dissection.
  
  
  METHODS
  All medically treated patients with acute type B aortic dissection observed in 4 cardiovascular referral centers between 1998 and 2011, with admission and follow-up computed tomography or magnetic resonance imaging scans, were included. Aortic diameters of the dissected aortas were measured at 4 levels on the baseline and follow-up scans, and annual growth rates were calculated. Univariate and multivariate regression analyses were used to investigate the effect of false lumen thrombosis on aortic growth rate.
  
  
  RESULTS
  A total of 84 patients were included, of whom 40 (47.6%) had a partially thrombosed false lumen, 7 (8.3%) had a completely thrombosed false lumen, and 37 (44.0%) had a patent false lumen. A total of 273 of the 336 (81.3%) evaluated aortic levels were dissected segments. Overall, the mean aortic diameter increased significantly at all evaluated levels (P < .001). Univariate analysis showed that annual aortic growth rates were significantly higher in those segments having a false lumen with partial thrombosis (mean, 4.25 ± 10.2) when compared with the patent group (mean, 2.10 ± 5.56; P = .035). In multivariate analysis, partial lumen thrombosis was an independent predictor of higher aortic growth (adjusted mean difference, 2.05 mm/year; 95% confidence interval, 0.10-4.01; P = .040).
  
  
  CONCLUSIONS
  In patients with acute type B aortic dissection, aortic segments with a partially thrombosed false lumen have a significantly higher annual aortic growth rate when compared with those presenting with patent or complete thrombosis of the false lumen. Therefore, patients with partial thrombosis require more intensive follow-up and may benefit from prophylactic intervention.
authors.affiliation: Thoracic Aortic Research Center, Policlinico San Donato IRCCS, Milan, Italy. santi.trimarchi@unimi.it
authors.forename: Santi
authors.initials: S
authors.lastname: Trimarchi
authors.forename: Jip L
authors.initials: JL
authors.lastname: Tolenaar
authors.forename: Frederik H W
authors.initials: FH
authors.lastname: Jonker
authors.forename: Brian
authors.initials: B
authors.lastname: Murray
authors.forename: Thomas T
authors.initials: TT
authors.lastname: Tsai
authors.forename: Kim A
authors.initials: KA
authors.lastname: Eagle
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Rampoldi
authors.forename: Hence J M
authors.initials: HJ
authors.lastname: Verhagen
authors.forename: Joost A
authors.initials: JA
authors.lastname: van Herwaarden
authors.forename: Frans L
authors.initials: FL
authors.lastname: Moll
authors.forename: Bart E
authors.initials: BE
authors.lastname: Muhs
authors.forename: John A
authors.initials: JA
authors.lastname: Elefteriades
mesh_terms: D000784:Aortic Dissection / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D001014:Aortic Aneurysm / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D001027:Aortography / Q000379:methods; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003237:Connecticut; D018450:Disease Progression; D005260:Female; D006801:Humans; D007558:Italy; D016014:Linear Models; D018810:Magnetic Resonance Angiography; D008297:Male; D015999:Multivariate Analysis; D009426:Netherlands; D011237:Predictive Value of Tests; D012307:Risk Factors; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents