Treatment patterns and their outcomes of acute aortic intramural hematoma in real world: multicenter registry for aortic intramural hematoma

摘要

Background Intramural hematoma of the aorta (IMH), a variant of classic aortic dissection, shows very dynamic process in the early phase. The aim of this study is to evaluate clinical outcomes of patients with acute aortic IMH from real world registry data. Methods We analyzed 165 consecutive patients with acute IMH from five medical centers in Korea. All patients were divided into two groups; type A (n?=?61, 37.0%) and type B (n?=?104, 63.0%) according to the Stanford classification. Clinical outcomes and morphological evolution by CT were analyzed for 2?years. Results Most of the patients (77.0% of type A and 99.0% of type B, P?P?=?0.671) and 2-year mortality (13.1% vs. 11.5%, P?=?0.765) between two groups. During the 2-year follow up period, progression to aortic dissection (18.0% vs. 6.7%, P?=?0.037) and surgical treatment (29.5% vs. 2.9%, P?P?=?0.428) and 2-year mortality (7.1% of surgery vs. 14.9% of medical, P?=?0.450) in terms of initial treatment strategy. Conclusion For real world practice in Korea, most of IMH patients were treated medically at presentation and showed favorable outcomes. Thus, even in type A acute IMH, early medical treatment with alternative surgical conversion for selected, complicated cases would be a favorable treatment option.