Journal of Shandong University (Health Sciences) ›› 2024, Vol. 62 ›› Issue (9): 108-114.doi: 10.6040/j.issn.1671-7554.0.2024.0322

• Advances in Basic and Clinical Research on Aortic Diseases-Clinical Research • Previous Articles    

Single-center experience in treatment of Stanford type B aortic intramural hematoma

ZHAO Wenpeng, LYU Fanzhen, HU Yiliang, CHEN Shai, FANG Huaqiang, WANG Shizhi, ZHOU Weimin   

  1. Department of Vascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
  • Published:2024-10-10

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Abstract: Objective To evaluate the treatment methods and outcomes for Stanford type B intramural hematoma(IMH). Methods A total of 368 patients with Stanford type B IMH admitted to the Second Affiliated Hospital of Nanchang University from August 2017 to May 2023 were selected for analysis of their clinical data and treatment outcomes. Results Based on the outcomes during follow-up, the patients were divided into the absorption group(n=134)and the progression group(n=234). Univariate analysis showed significant differences between the absorption and progression groups in terms of age ［(60.59±11.14)years vs(61.86±12.05)years］, platelet count ［206.00(88.07)×109/L vs 187.00(86.00)×109/L］, aspartate aminotransferase ［18.60(19.37)U/L vs 19.50(7.80)U/L］, maximum diameter of the descending aorta ［35(6)vs 34(5)mm］, and distal hematoma involvement of Zone 6-11 ［157(66.81%)vs 66(49.25%)］(P<0.05). Multivariate Logistic regression analysis indicated that the maximum diameter of the descending aorta was an independent risk factor for the progression of Stanford type B IMH(OR=0.943, 95%CI=0.899-0.990, P=0.017). The average follow-up time for discharged patients was(35.1±17.9)months, with a loss to follow-up rate of 6.8%. The 5-year survival rate post-discharge was 77.4% for the patient with medication treatment and 87.6% for the patient with endovascular treatment. Conclusion Single-center experience suggests that endovascular treatment for Stanford type B IMH is safe and effective. For patients with dilation of the descending aorta, vigilance is required for the progression of intramural hematoma, and surgical intervention may be considered when necessary.

Key words: Aortic intramural haematoma, Thoracic endovascular aortic repair, Ulcer-like projections, Penetrating atherosclerotic ulcer, Intramural blood pools

CLC Number: 

  • R543.1
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