Relationship of vascular pathology, demographic and radio-anatomical features in aortic dissections detected by multidetector CT

Yusuf Secgın 1, Serkan Oner 2 * , Zulal Oner 3
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1 Department of Anatomy, Faculty of Medicine, Karabük University, Karabük, Turkey
2 Department of Radiology, Faculty of Medicine, Izmir Bakırcay University, Izmir, Turkey
3 Department of Anatomy, Faculty of Medicine, Izmir Bakırcay University, Izmir, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 18, Issue 6, pp. 40-44. https://doi.org/10.23950/jcmk/11325
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ABSTRACT

Aim: Aortic dissection is a cardiovascular disease with low incidence but high mortality. The aim of our study is to evaluate the demographic, vascular pathologic and radio-anatomic features of aortic dissection and find out the relationship of these with aortic dissection.
Methods: One female and 12 male patients admitted to the hospital with severe chest pain and diagnosed with aortic dissection by Computed Tomography were included in this study. Patients were divided into three groups according to the De Bakey classification. Type I: starting from the ascending aorta and ending in the thoracic aorta, Type II: starting from the ascending aorta and ending in the brachiocephalic artery, Type III: starting from the subclavian artery and ending at the level of the diaphragm and abdomen.
Results: The highest aortic dissection incidence was found in group Type III with 54%. The ages of patients with aortic dissection were 56.67±12.50, 61.00±11.53 and 52.00±12.26, respectively according to the groups. According to the Pearson Correlation test, significant correlations were found between ascending aorta and age and aortic arch, between cardiothoracic ratio and heart width, and between thoracic width and thoracic aorta (p≤0.05). One Way Anova test was used for the analysis between dissection groups and significant correlation was found between Type II and Type III groups of ascending aorta parameter (p≤0.05). In addition, it was found that 54% of the patients had mild atherosclerosis and 46% had lumen.
Conclusion: A significant relationship was found between aortic dissection and radio-anatomic parameters, demographic and vascular pathologic features.
Keywords: Aortic dissection, Computed tomography, De Bakey classification

CITATION

Secgın Y, Oner S, Oner Z. Relationship of vascular pathology, demographic and radio-anatomical features in aortic dissections detected by multidetector CT. J CLIN MED KAZ. 2021;18(6):40-4. https://doi.org/10.23950/jcmk/11325

REFERENCES

  • Finkelmeier BA, Marolda D. Aortic dissection. J Cardiovasc Nurs. 2001;15(4):15-24. https://doi.org/10.1097/00005082-200107000-00003
  • Deplano V, Boufi M, Gariboldi V, Loundou AD, D'Journo XB, Cautela J, et al. Mechanical characterisation of human ascending aorta dissection. J Biomech. 2019;94:138-46. https://doi.org/10.1016/j.jbiomech.2019.07.028
  • Gawinecka J, Schonrath F, von Eckardstein A. Acute aortic dissection: pathogenesis, risk factors and diagnosis. Swiss Med Wkly. 2017;147:w14489. https://doi.org/10.4414/smw.2017.14489
  • Criado FJ. Aortic dissection: a 250-year perspective. Tex Heart Inst J. 2011;38(6):694-700. PMID: 22199439
  • Tchana-Sato V, Sakalihasan N, Defraigne JO. Aortic dissection. Rev Med Liege. 2018;73(5-6):290-5. PMID: 29926568
  • Hughes GC. Management of acute type B aortic dissection; ADSORB trial. The Journal of thoracic and cardiovascular surgery. 2015;149(2):S158-S62. https://doi.org/10.1016/j.jtcvs.2014.08.083
  • Elsayed RS, Cohen RG, Fleischman F, Bowdish ME. Acute type A aortic dissection. Cardiology clinics. 2017;35(3):331-45. https://doi.org/10.1016/j.ccl.2017.03.004
  • Davy H, Gates M. A case of dissecting aneurysm of the aorta. British medical journal. 1922;1(3195):471. https://doi.org/10.1136/bmj.1.3195.471
  • LePage MA, Quint LE, Sonnad SS, Deeb GM, Williams DM. Aortic dissection: CT features that distinguish true lumen from false lumen. American Journal of Roentgenology. 2001;177(1):207-11. https://doi.org/10.2214/ajr.177.1.1770207
  • McMahon MA, Squirrell CA. Multidetector CT of aortic dissection: a pictorial review. Radiographics. 2010;30(2):445-60. https://doi.org/10.1148/rg.302095104
  • Maunoir JP. Mémoires physiologiques et pratiques sur l'anévrisme et la ligature des artères: Paschoud; 1802.
  • Kruger T, Forkavets O, Veseli K, Lausberg H, Vohringer L, Schneider W, et al. Ascending aortic elongation and the risk of dissection. Eur J Cardiothorac Surg. 2016;50(2):241-7. https://doi.org/10.1093/ejcts/ezw025
  • Schwartz SI, Durham C, Clouse WD, Patel VI, Lancaster RT, Cambria RP, et al. Predictors of late aortic intervention in patients with medically treated type B aortic dissection. J Vasc Surg. 2018;67(1):78-84. https://doi.org/10.1016/j.jvs.2017.05.128
  • Hines G, Dracea C, Katz DS. Diagnosis and management of acute type A aortic dissection. Cardiol Rev. 2011;19(5):226-32. https://doi.org/10.1097/CRD.0b013e3182203ed9
  • Heuts S, Adriaans BP, Rylski B, Mihl C, Bekkers S, Olsthoorn JR, et al. Evaluating the diagnostic accuracy of maximal aortic diameter, length and volume for prediction of aortic dissection. Heart. 2020;106(12):892-7. https://doi.org/10.1136/heartjnl-2019-316251
  • Gode S, Akinci O, Ustunisik CT, Sen O, Kadirogullari E, Aksu T, et al. The role of the angle of the ascending aortic curvature on the development of type A aortic dissection: ascending aortic angulation and dissection. Interact Cardiovasc Thorac Surg. 2019;29(4):615-20. https://doi.org/10.1093/icvts/ivz144
  • Kruger T, Sandoval Boburg R, Lescan M, Oikonomou A, Schneider W, Vohringer L, et al. Aortic elongation in aortic aneurysm and dissection: the Tubingen Aortic Pathoanatomy (TAIPAN) project. Eur J Cardiothorac Surg. 2018;54(1):26-33. https://doi.org/10.1093/ejcts/ezx503
  • Koechlin L, Macius E, Kaufmann J, Gahl B, Reuthebuch O, Eckstein F, et al. Aortic root and ascending aorta dimensions in acute aortic dissection. Perfusion. 2020;35(2):131-7. https://doi.org/10.1177/0267659119858848
  • Wu JL, Zhang L, Qiu JT, Yu CT. Morphological features of the thoracic aorta and supra-aortic branches in patients with acute Type A aortic dissection in China. Interact Cardiovasc Thorac Surg. 2018;27(4):555-60. https://doi.org/10.1093/icvts/ivy110
  • Barbetseas J, Alexopoulos N, Brili S, Aggeli C, Chrysohoou C, Frogoudaki A, et al. Atherosclerosis of the aorta in patients with acute thoracic aortic dissection. Circ J. 2008;72(11):1773-6. https://doi.org/10.1253/circj.CJ-08-0433