title: Treatment patterns and their outcomes of acute aortic intramural hematoma in real world: multicenter registry for aortic intramural hematoma.
abstract: BACKGROUND
  Intramural hematoma of the aorta (IMH), a variant of classic aortic dissection, shows very dynamic process in the early phase. The aim of this study is to evaluate clinical outcomes of patients with acute aortic IMH from real world registry data.
  
  
  METHODS
  We analyzed 165 consecutive patients with acute IMH from five medical centers in Korea. All patients were divided into two groups; type A (n = 61, 37.0%) and type B (n = 104, 63.0%) according to the Stanford classification. Clinical outcomes and morphological evolution by CT were analyzed for 2 years.
  
  
  RESULTS
  Most of the patients (77.0% of type A and 99.0% of type B, P < 0.001) were treated medically during their initial hospitalization. There were no significant differences in in-hospital mortality (4.9% vs. 2.9%, P = 0.671) and 2-year mortality (13.1% vs. 11.5%, P = 0.765) between two groups. During the 2-year follow up period, progression to aortic dissection (18.0% vs. 6.7%, P = 0.037) and surgical treatment (29.5% vs. 2.9%, P < 0.001) were higher in type A. For the type A patients, there were no significant difference in in-hospital mortality (7.1% of surgery vs. 4.3% of medical, P = 0.428) and 2-year mortality (7.1% of surgery vs. 14.9% of medical, P = 0.450) in terms of initial treatment strategy.
  
  
  CONCLUSIONS
  For real world practice in Korea, most of IMH patients were treated medically at presentation and showed favorable outcomes. Thus, even in type A acute IMH, early medical treatment with alternative surgical conversion for selected, complicated cases would be a favorable treatment option.
authors.forename: Yoon-Jung
authors.initials: YJ
authors.lastname: Choi
authors.forename: Jang-Won
authors.initials: JW
authors.lastname: Son
authors.forename: Sang-Hee
authors.initials: SH
authors.lastname: Lee
authors.forename: Ung
authors.initials: U
authors.lastname: Kim
authors.forename: Dong-Gu
authors.initials: DG
authors.lastname: Shin
authors.forename: Young-Jo
authors.initials: YJ
authors.lastname: Kim
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Hur
authors.forename: Chang-Wook
authors.initials: CW
authors.lastname: Nam
authors.forename: Yun-Kyeong
authors.initials: YK
authors.lastname: Cho
authors.forename: Bong-Ryul
authors.initials: BR
authors.lastname: Lee
authors.forename: Byung-Chun
authors.initials: BC
authors.lastname: Jeong
authors.forename: Jin-Bae
authors.initials: JB
authors.lastname: Lee
authors.forename: Jae-Kean
authors.initials: JK
authors.lastname: Ryu
authors.forename: Hun-Sik
authors.initials: HS
authors.lastname: Park
authors.forename: Jang-Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Se-Yong
authors.initials: SY
authors.lastname: Jang
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, 170, Hyeonchung-ro, Nam-gu, Daegu 705-717, Republic of Korea. pjs@med.yu.ac.kr.
authors.forename: Jong-Seon
authors.initials: JS
authors.lastname: Park
mesh_terms: D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D001027:Aortography / Q000379:methods; D005260:Female; D006406:Hematoma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality / Q000639:trends*