scholarly journals Distal Aortic Intramural Hematoma: Clinical Importance of Focal Contrast Enhancement on CT Images

Radiology ◽  
2011 ◽  
Vol 259 (1) ◽  
pp. 100-108 ◽  
Author(s):  
Gyung-Min Park ◽  
Jung-Min Ahn ◽  
Dae-Hee Kim ◽  
Joon-Won Kang ◽  
Jong-Min Song ◽  
...  
Keyword(s):  
Contrast Enhancement ◽  
Clinical Importance ◽  
Intramural Hematoma ◽  
Ct Images ◽  
Aortic Intramural Hematoma

Prediction of Progression or Regression of Type A Aortic Intramural Hematoma by Computed Tomography

Circulation ◽  
1999 ◽  
Vol 100 (suppl_2) ◽  
Author(s):  
Shuichiro Kaji ◽  
Kazuhiro Nishigami ◽  
Takashi Akasaka ◽  
Takeshi Hozumi ◽  
Tsutomu Takagi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Wall Thickness ◽  
Aortic Wall ◽  
Intramural Hematoma ◽  
Type A ◽  
Ct Images ◽  
Aortic Diameter ◽  
Aortic Wall Thickness ◽  
Aortic Intramural Hematoma

Background —It has been reported that early surgery should be required for patients with type A aortic intramural hematoma (IMH) because it tends to develop classic aortic dissection or rupture. However, the anatomic features of type A IMH that develops dissection or rupture are unknown. The purpose of this study was to investigate the predictors of progression or regression of type A IMH by computed tomography (CT). Methods and Results —Twenty-two consecutive patients with type A IMH were studied by serial CT images. Aortic diameter and aortic wall thickness of the ascending aorta were estimated in CT images at 3 levels on admission and at follow-up (mean 37 days). We defined patients who showed increased maximum aortic wall thickness in the follow-up CT (n=9) or died of rupture (n=1) as the progression group (n=10). The other 12 patients, who all showed decreased maximum wall thickness, were categorized as the regression group. In the progression group, the maximum aortic diameter in the initial CT was significantly greater than that in the regression group (55±6 vs 47±3 mm, P =0.001). A Cox regression analysis revealed that the maximum aortic diameter was the strongest predictor for progression of type A IMH. We considered the optimal cutoff value to be 50 mm for the maximum aortic diameter to predict progression (positive predictive value 83%, negative predictive value 100%). Conclusions —Maximum aortic diameter estimated by the initial CT images is predictive for progression of type A IMH.

Acute Aortic Intramural Hematoma Presenting with Painless Recurrent Syncope

2012 ◽  
Vol 15 (5) ◽  
pp. 286
Author(s):  
Jan Droste ◽  
Heidar Zafarani Zadeh ◽  
Mohammed Arif ◽  
Ian Craig ◽  
A K Thakur
Keyword(s):  
Aortic Wall ◽  
Surgical Intervention ◽  
Intramural Hematoma ◽  
Pericardial Tamponade ◽  
Transthoracic Echocardiogram ◽  
Type A Aortic Dissection ◽  
Severe Hypotension ◽  
Patient’S History ◽  
Aortic Intramural Hematoma ◽  
Venous Pulse

<p>A patient presented with recurrent syncope due to transient severe hypotension. The patient's history, physical examination, and initial baseline investigation did not suggest a cardiovascular cause. After fluid resuscitation, a raised jugular venous pulse was noted. Bedside transthoracic echocardiogram showed a pericardial effusion and a proximally dilated aorta. Computed tomography of the thorax confirmed these findings and also demonstrated an intramural hematoma of the proximal aortic wall.</p><p>The patient was transferred to a cardiothoracic center, where he was at first treated medically. He then developed sudden cardiogenic shock due to pericardial tamponade and was successfully operated on.</p><p>It is important to recognize an acute intramural hematoma of the proximal aortic wall as a cardiothoracic emergency. This condition can present atypically, but nevertheless warrants urgent surgical intervention, equal to type A aortic dissection. Echocardiography can help in making the diagnosis.</p>

Abdominal Aortic Intramural Hematoma Related to Penetrating Ulcer:An Inappropriate Indication for Endovascular Repair?

2003 ◽  
Vol 10 (2) ◽  
pp. 392-396 ◽  
Author(s):  
Marco Ventura ◽  
Alessandro Mastromarino ◽  
Lucia Cucciolillo ◽  
Giuseppe Calvisi ◽  
Carlo Spartera
Keyword(s):  
Endovascular Repair ◽  
Intramural Hematoma ◽  
Abdominal Aortic ◽  
Aortic Intramural Hematoma

scholarly journals Analysis of predictive factors for progression of type B aortic intramural hematoma with computed tomography

2002 ◽  
Vol 35 (6) ◽  
pp. 1179-1183 ◽  
Author(s):  
Eijun Sueyoshi ◽  
Tatsuya Imada ◽  
Ichiro Sakamoto ◽  
Yohjiro Matsuoka ◽  
Kuniaki Hayashi
Keyword(s):  
Computed Tomography ◽  
Predictive Factors ◽  
Intramural Hematoma ◽  
Type B ◽  
Aortic Intramural Hematoma

ORIGINAL INVESTIGATIONS: Different Clinical Features of Aortic Intramural Hematoma Versus Dissection Involving the Descending Thoracic Aorta

2005 ◽  
Vol 22 (8) ◽  
pp. 629-635 ◽  
Author(s):  
Mariano Falconi ◽  
Pablo Oberti ◽  
Juan Krauss ◽  
Alberto Domenech ◽  
Vicente Cesáreo ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
Clinical Features ◽  
Intramural Hematoma ◽  
Descending Thoracic Aorta ◽  
Aortic Intramural Hematoma

Abstract 15182: Acute Complications of Type B Aortic Intramural Hematoma Compared With Classic Aortic Dissection

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yutaro Miyoshi ◽  
Shuichirou Kaji ◽  
Akiko Masumoto ◽  
Toshiaki Toyota ◽  
Taiji Okada ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Hospital Mortality ◽  
Clinical Course ◽  
Aortic Rupture ◽  
Intramural Hematoma ◽  
Spinal Ischemia ◽  
Type B ◽  
Impending Rupture ◽  
Acute Complications ◽  
Aortic Intramural Hematoma

Introduction: Although acute type B aortic intramural hematoma (B-IMH) is a variant of acute aortic syndrome having similar clinical demographics to type B classic aortic dissection (B-AD), early clinical course including acute complications are not well investigated. The purpose of this study was to investigate early clinical course and acute complications of B-IMH in comparison with that of B-AD. Methods: Clinical features and early clinical course including acute complications were retrospectively analyzed in 270 B-IMH and 177 B-AD consecutive patients who were admitted to our hospital between 1991 and 2020. Acute complications were defined as rupture, impending rupture, re-dissection, and visceral and leg ischemia. Results: As compared with B-AD, B-IMH presented at older age (72±11 vs 62±15 years; p&lt;0.001), predominantly in females (37% vs 25%). During in-hospital courses, limb ischemia and mesenteric ischemia were less common in patients with B-IMH than those with B-AD (0.4% versus 5.1%, p=0.003, 0.4% versus 2.8%, p=0.03; respectively). In contrast, spinal ischemia was more common in B-IMH patients (2.4% versus 0.6%, p=0.05). Aortic rupture and impending rupture were comparable between B-IMH and B-AD patients (5.9% versus 7.3%. p=0.28). Besides, re-dissection was also comparable between two groups (2.2% versus 5.1%, p=0.06). As a result, prevalence of acute complications was significantly lower in patients with B-IMH (8.8% versus 17%, p=0.008). In-hospital mortality rate in B-IMH was significantly lower than that in B-AD (0.4% versus 9.0%, p&lt;0.001). Conclusions: Although patients with B-IMH had lower in-hospital mortality rates than patients with B-AD, significant portion of B-IMH patients had fatal complications including spinal ischemia or aortic rupture. Patients with B-IMH should be carefully observed as well as patients with B-AD patients.

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