Morphologic predictors of aortic expansion in chronic XXXX .

@entity1 @entity384 @entity1514 @entity1580
AIM: To identify morphologic factors affecting aortic expansion in @entity1 with uncomplicated type B aortic dissections. METHODS: Computed tomography data of 24 @entity1 (18 male; median age: 61 years), diagnosed with acute uncomplicated type B aortic dissections between 2002 and 2013, were retrospectively reviewed. All @entity1 had at least two computed tomography angiography scans and six months of uneventful follow-up. Computed tomography scans were assessed by two independent readers with regard to presence and number of entry tears. @entity1514 and abdominal aortic diameters were derived using image processing software. RESULTS: Twenty-two of 24 @entity1 showed aortic expansion over a median computed tomography angiographic follow-up of 33.2 months. Annual rates showed an increase of 1.7   mm for total aortic diameter, 2.1   mm for the false and a decrease of -0.4   mm for the true lumen. In three @entity1 (12.5%), aortic diameter exceeded 60   mm during follow-up, and all three @entity1 underwent thoracic endovascular aortic repair. @entity1 with a maximum aortic diameter <4   cm at baseline showed a significantly higher expansion rate compared to cases with an initial maximum aortic diameter of >= 4   cm (p=0.0471). A median of two entries (range: 1-5) was recognized per @entity1 . Presence of more than two entry tears (n   =   13) was associated with faster overall diameter expansion (mean annual rates: 2.18   mm vs. 1.16   mm; p   =   0.4556), and decrease of the cross-sectional surface of the true lumen over time (annual rate for   >   2 entries vs.  <=2 entries: -7.8   mm(2) vs. +37.5   mm(2); p   =   0.0369). Median size of entry tears was 12   mm (range: 2-53   mm). CONCLUSIONS: The results presented herein suggest that uncomplicated @entity1580 @entity1 with more than two entry tears and/or an initial maximum aortic diameter of<4 cm are at risk for @entity384 and, therefore, may require stricter follow-up including the possible need for early intervention.
