Clinical features of elderly female patients with Stanford B aortic dissection managed with endovascular intervention

AIM:To summarize the clinical features of elderly female patients with Stanford B aortic dissection. METHODS: Clinical features and hospital outcomes and during follow-up were retrospectively analyzed in both groups: elderly male patient group (≥60 years, n=61) and elderly female patient group (≥60 years, n=30) who suffered from Stanford B aortic dissection and were treated with endovascular intervention between April 2002 and July 2011. Average ages were (67±5) and (66±5) years, respectively. RESULTS: Average ages and proportion of patients’ ≥70 years were similar in both groups. No statistical differences were found between groups in the proportions according to smoking history, diabetes mellitus, coronary artery disease and hyperlipemia. In the group of elderly female patients, the rate of known hypertension was lower and the rate of first-time diagnosis of hypertension was higher than those in the elderly male group (P<0.05). No statistical differences were observed between groups in the constituent ratios of etiology including hypertension and penetrating atherosclerotic ulcer. The rate of hospital visit ≥24 h from the appearance of symptoms was higher in the group of elderly females than that in elderly male group (P<0.05). There were no statistical differences between groups in the incidences of chest/back pains, gastrointestinal upset, lower limb pain, dyspnea, hemoptysis, apopsychia, complications of hemothorax, cardiac or renal insufficiency, and hypoxemia. The group of elderly female patients presented less frequently with abrupt onset (P<0.05). The success ratio of endovascular therapy was 100% in the two groups. Lengths and diameters of aorta covered by stent grafts, incidences of endovascular leakage, postimplantation syndrome (transient elevations of body temperature and C-reactive protein and mild leukocytosis) and incisional infections showed no statistical differences between groups. One elderly male patient died due to aortic dissection and no deaths occurred in the group of elderly female patients during hospitalization. No statistical differences between groups were seen in hospital mortality as well as total mortality and mortality related to aortic dissection during follow-up. CONCLUSION: The group of elderly female patients with Stanford B aortic dissection is characterized by a lower rate of known hypertension and abrupt onset and later appearance. Better understanding of these clinical features will contribute to earlier diagnosis, more appropriate therapeutic options and, as a consequence, better outcome.