title: Computed tomography evaluation of aortic remodeling after endovascular treatment for complicated ulcer-like projection in patients with type B aortic intramural hematoma.
abstract: OBJECTIVE
  The purpose was to investigate changes of the affected aorta after endovascular treatment for complicated ulcer-like projection (ULP), including aneurysmal change or rupture of ULP, or both, in patients with type B aortic intramural hematoma (IMH).
  
  
  METHODS
  The study evaluated 18 patients (nine men) undergoing thoracic endovascular aortic repair for progressive aneurysmal formation of ULP (n = 17), rupture of ULP (n = 5), or both. Patients were a median age of 72 years (range, 45-83 years). Regular follow-up computed tomography studies were performed after treatment (mean follow-up, 61.2 months). A workstation was used to calculate changes on computed tomography images in the size or volume of ULP, affected aorta, and IMH. The growth rate of the volume of the affected aorta and IMH was also calculated before and after treatment. We evaluated the data using the paired t-test.
  
  
  RESULTS
  A stent graft was successfully deployed and ULPs disappeared in all patients. IMH disappeared in 16 or decreased in two after treatment. There were significant differences in the mean maximum aortic diameter (37.8 ± 5.2 vs 34.5 ± 5.2 mm; P = .0006), mean IMH volume (39.4 ± 12.1 vs 2.0 ± 6.0 mL; P < .0001), and total volume of the aorta with IMH (158.1 ± 40.2 vs 128.9 ± 28.0 mL; P < .0001) before and after treatment.
  
  
  CONCLUSIONS
  Endovascular treatment is a useful treatment for complicated ULP in patients with IMH. Endovascular treatment also contributes to ideal remodeling of the affected aorta.
authors.affiliation: Department of Radiology, Nagasaki University School of Biomedical Sciences, Nagasaki, Japan. Electronic address: sueyo@nagasaki-u.ac.jp.
authors.forename: Eijun
authors.initials: E
authors.lastname: Sueyoshi
authors.affiliation: Department of Radiology, Nagasaki University School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nagayama
authors.affiliation: Department of Cardiovascular Surgery, Nagasaki University School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Hashizume
authors.affiliation: Department of Cardiovascular Surgery, Nagasaki University School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Kiyoyuki
authors.initials: K
authors.lastname: Eishi
authors.affiliation: Department of Radiology, Nagasaki University School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Sakamoto
authors.affiliation: Department of Radiology, Nagasaki University School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Uetani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D057510:Endovascular Procedures / Q000295:instrumentation; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014456:Ulcer / Q000000981:diagnostic imaging / Q000601:surgery*