title: Predictors of late aortic events after Stanford type B acute aortic dissection.
abstract: OBJECTIVE
  Patients with Stanford type B acute aortic dissection usually receive medical treatment during the acute phase. The present study aimed to elucidate the factors predicting late aortic events in patients treated conservatively for acute type B dissections.
  
  
  METHODS
  From March 1991 to March 2011, 117 patients were enrolled in the present study, with a mean follow-up period of 5.1 ± 4.1 years. The patients were divided into 4 groups according to their false lumen status at onset: group F, fully open (n = 26, 22.2%); group P, partially thrombosed (n = 23, 19.6%); group U, ulcer-like projections (n = 22, 18.9%); and group T, completely thrombosed (n = 46, 39.3%).
  
  
  RESULTS
  Long-term survival did not significantly differ among the groups. The Kaplan-Meier event-free rate curve showed that aortic events occurred less frequently in group T than in the other 3 groups; the 5-year event-free rate was 65.4%, 58.8%, 36.1%, and 95.7% for groups F, P, U, and T, respectively. Cox regression analysis showed that the presence of ulcer-like projections (P = .016) and a maximum aortic diameter of ≥ 40 mm (P = .003) were predictors of late aortic events.
  
  
  CONCLUSIONS
  When patients have a maximum aortic diameter of ≥40 mm or ulcer-like projections at onset, early surgical intervention should be considered to prevent positive remodeling of the aorta.
authors.affiliation: Division of Cardiac Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kudo
authors.affiliation: Division of Cardiac Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Mikamo
authors.affiliation: Division of Cardiac Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kurazumi
authors.affiliation: Division of Cardiac Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Suzuki
authors.affiliation: Division of Cardiac Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
authors.forename: Noriyasu
authors.initials: N
authors.lastname: Morikage
authors.affiliation: Division of Cardiac Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan. Electronic address: kimikazu@yamaguchi-u.ac.jp.
authors.forename: Kimikazu
authors.initials: K
authors.lastname: Hamano
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D001019:Aortic Rupture / Q000601:surgery; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D016009:Chi-Square Distribution; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D013927:Thrombosis; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome