Clinical features and imaging analysis of aortic adverse events in Stanford type B intramural aortic hematoma

  AIM  To evaluate the clinical characteristics and prognostic factors of aortic related adverse events in patients with Stanford type B intramural hematoma (IMH).

  METHODS  A total of 579 patients with IMH admitted to the General Hospital of the Northern Theater Command from April 2013 to March 2021 were retrospectively analyzed and patients who did not meet the inclusion criteria and had incomplete clinical follow-up data were excluded. Finally, 372 patients with Stanford type B intramural haematoma were enrolled in this study. According to whether or not the patients had aortic related adverse events, the patients were divided into the event group and the control group, and the clinical characteristics and the first imaging characteristics at diagnosis of the two groups were observed.

  RESULTS  Among the 372 patients, 81 patients (21.7%) who had aortic related adverse events were assigned to the event group and 291 patients who had no aortic related adverse events served as the control group. There were no significant differences in gender, smoking history, history of hypertension, history of diabetes and history of cerebrovascular disease between the two groups. The mean age of patients in the event group was younger than that in the control group (59±11 years) vs. (65±10 years), P<0.001. The logistic multivariate regression analysis was performed to compare the clinical characteristics and the parameters of the first diagnosed aortic enhancement CT (CTA) in the two groups. Age (OR = 0.943, 95%CI: 0.913-0.974, P<0.001), the maximum descending aorta diameter measured in CTA (OR = 1.325, 95%CI: 1.231-1.425, P<0.001) and intramural haematoma with ulcer-like projection (OR = 3.975, 95%CI: 1.744-9.060, P = 0.001) were independent risk factors for aortic related adverse events in patients with IMH.

  CONCLUSIONS  Single-center data indicate that for Stanford type B IMH patients, younger age at first diagnosis, increased maximum descending aorta diameter in the first CTA and associated ulcer-like projection can predict the occurrence of aortic related adverse events.