Aortic Morphology Changes During Computed Tomography Based Follow Up After Thoracic Endovascular Aortic Repair for Type B Aortic Intramural Hematoma
Presented During:
Monday, May 4, 2026: 9:00AM - 4:00PM
McCormick Place Lakeside Center
Posted Room Name:
Exhibit Hall, Poster Area
Abstract No:
P0115
Submission Type:
Abstract Submission
Authors:
Chuan Tian (1)
Institutions:
(1) Fuwai Hospital, Beijing, Beijing
Submitting Author:
Chuan Tian
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Fuwai Hospital
Fuwai Hospital
Abstract:
Objective: Aortic morphology changes and survival outcomes after thoracic endovascular aortic repair for patients with type B aortic intramural hematoma remain unclear.
Methods: Participants were consecutively recruited from an institutional registry for acute aortic syndrome between September 2014 and August 2021. We enrolled patients who underwent TEVAR for type B IMH and evaluated the aortic morphological changes based on follow-up computed tomography angiography and clinical outcomes.
Results: The cohort consists of 292 patients (76.0 % male and 24.0% female) with a median age of 62 (interquartile range: 52-68) years old. During the imaging follow-up of 289 (99%) patients, the majority achieved morphological stability or regression (85.5% of female patients and 82.3% of male patients). Both the maximum descending aortic diameter (decreasing from 35.4 mm to 33.4 mm, P < 0.001) and maximum hematoma thickness (decreasing from 10.2 mm to 3.4 mm, P < 0.001) showed significant reductions. Female patients exhibited a higher incidence of newly developed ascending aortic dissection (5.8%, 4/69) compared to male patients (1.4%, 3/220) (P = 0.04). During clinical follow-up (median: 4.0 years, interquartile range: 2.4-5.8 years), the Kaplan Meier estimated 5-year mortality rates were 17.9% for females and 7.5% for males (P=0.02). In multivariable COX regression analysis, female patients were associated with a higher risk of follow-up death (hazard ratio: 2.43, 95% confidence interval: 1.10-5.35, P = 0.03).
Conclusions: Patients with type B IMH demonstrated significant morphological regression in aortic diameter and hematoma thickness following TEVAR. Additionally, female patients were associated with increased risks of newly developed ascending aortic dissection and higher follow-up mortality compared to their male counterparts.
Methods: Participants were consecutively recruited from an institutional registry for acute aortic syndrome between September 2014 and August 2021. We enrolled patients who underwent TEVAR for type B IMH and evaluated the aortic morphological changes based on follow-up computed tomography angiography and clinical outcomes.
Results: The cohort consists of 292 patients (76.0 % male and 24.0% female) with a median age of 62 (interquartile range: 52-68) years old. During the imaging follow-up of 289 (99%) patients, the majority achieved morphological stability or regression (85.5% of female patients and 82.3% of male patients). Both the maximum descending aortic diameter (decreasing from 35.4 mm to 33.4 mm, P < 0.001) and maximum hematoma thickness (decreasing from 10.2 mm to 3.4 mm, P < 0.001) showed significant reductions. Female patients exhibited a higher incidence of newly developed ascending aortic dissection (5.8%, 4/69) compared to male patients (1.4%, 3/220) (P = 0.04). During clinical follow-up (median: 4.0 years, interquartile range: 2.4-5.8 years), the Kaplan Meier estimated 5-year mortality rates were 17.9% for females and 7.5% for males (P=0.02). In multivariable COX regression analysis, female patients were associated with a higher risk of follow-up death (hazard ratio: 2.43, 95% confidence interval: 1.10-5.35, P = 0.03).
Conclusions: Patients with type B IMH demonstrated significant morphological regression in aortic diameter and hematoma thickness following TEVAR. Additionally, female patients were associated with increased risks of newly developed ascending aortic dissection and higher follow-up mortality compared to their male counterparts.
ADULT CARDIAC:
Aorta and Great Vessels
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