Morphologic predictors of in hospital mortality in acute type III aortic dissection.
BACKGROUND
In-hospital mortality of acute aortic type III dissection ranged about 12%. Complicated dissections represent about 18% of all cases, and require open surgery or TEVAR. More morphological predictors of in hospital mortality are needed to differentiate patients who should be selected for immediate, surgical or endovascular intervention.


METHODS
From January 2009 to December 2014, 74 patients with acute aortic type III dissection were enrolled at Clinic of Vascular and Endovascular Surgery in Belgrade Serbia and retrospectively analyzed. Every MSCT was observed in regard to morphologic characteristics of dissection.


RESULTS
By analyzing morphologic parameters in patients between survival and non-survival group only localization of intimal tear showed statistical significance (p=0,020). The size of the intimal tear didn't reach statistical significance with the tendency of doing so in a larger sample of patients (p=0,063) with the cut-off value of 9.55mm. The shape of the true lumen was on the border of statistical significance (p=0,053).


CONCLUSIONS
Inner curvature intimal tear localization, huge intimal tear as well as elliptic shape of the true lumen together should raise awareness to a subgroup at risk for in hospital mortality. More liberal endovascular treatment in this subgroup of patients is advocated.
Clinical Centre of Montenegro, Podgorica, Montenegro.
N
N
Fatic
Clinic for vascular and endovascular surgery, Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
N
N
Ilić
Clinic for vascular and endovascular surgery, Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
D
D
Markovic
Clinical Centre of Montenegro, Podgorica, Montenegro.
A
A
Nikolic
Clinic for vascular and endovascular surgery, Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
I
I
Končar
Clinical Centre of Montenegro, Podgorica, Montenegro.
R
R
Lazovic
Clinic for vascular and endovascular surgery, Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
I
I
Banzic
Clinical Centre of Montenegro, Podgorica, Montenegro.
G
G
Vuktsevich
Clinical Centre of Montenegro, Podgorica, Montenegro.
B
B
Pajovic
Clinic for vascular and endovascular surgery, Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
D
D
Kostic
D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery; D001011:Aorta / Q000000981:diagnostic imaging / Q000473:pathology; D001014:Aortic Aneurysm / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods / Q000706:statistics & numerical data*; D057510:Endovascular Procedures / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D055771:Serbia / Q000453:epidemiology; D016019:Survival Analysis