Expansion Rate of Thoracic Aortic Aneurysms and Influencing Factors

Masuda, Yoshiaki; Takanashi, Kazunori; Takasu, Junichiro; Morooka, Nobuhiro; Inagaki, Yoshiaki

doi:10.1378/chest.102.2.461

Cited by 105 publications

(50 citation statements)

References 15 publications

(2 reference statements)

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“…However, there were only a few reports on the growth rate of thoracic aortic aneurysm (TAA) that demonstrated that the growth rate had a range of 1.3 to 4.3 mm/year. 4,5,7 In the present study, the growth rate of AD in the thoracic aorta was 4.1 mm/year, and the ADs in the thoracic aorta grew at a faster rate than those in the abdominal aorta. These results were similar to some results in previous studies.…”

Section: Discussionsupporting

confidence: 46%

“…4,5,16,17 According to these results, the growth rate of AAA had a range of 2.2 to 5.7 mm/year. 4,5,16,17 Although AD and aortic aneurysm ultimately have different natural histories, the growth rate of the abdominal aorta in our results was 1.2 mm/year, which was slower than previous reports. For this reason, the aortic diameter of AD may usually be smaller than that of AAA.…”

Section: Discussionmentioning

confidence: 97%

“…4 In contrast, another study showed that the mean growth rate of TAA was significantly lower than that of AAA. 5 In fact, it is still unclear whether the mean growth rate of TAA is significantly lower than that of AAA. Some articles suggested that the mechanism of slow growth rate of TAA could be explained by the aortic structure itself.…”

Section: Discussionmentioning

confidence: 99%

“…The lamellar unit and vasa vasorum are normally absent in the human abdominal aortic media. 4,5,18 Therefore, elevated tension per lamellar unit and excessive avascular media may be factors in the increased growth rate of AAA. 4,5 However, in AD, the aortic wall is separated and directly damaged more than an aortic aneurysm.…”

Section: Discussionmentioning

confidence: 99%

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Growth Rate of Aortic Diameter in Patients With Type B Aortic Dissection During the Chronic Phase

Sueyoshi

Sakamoto²,

Hayashi³

et al. 2004

Circulation

160

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Background-The purpose of this study was to evaluate the growth rate of type B double-barrel aortic dissection with computed tomography (CT) and the factors influencing its enlargement. Methods and Results-Sixty-two patients were entered into this study, and regular follow-up CT studies (mean; 49.1 months) were performed. The affected aortas and iliac arteries were divided into 5 segments (aortic arch, descending thoracic, suprarenal abdominal, infrarenal abdominal aorta, and iliac artery). Fifty-two of 62 patients (83.9%) had 1 or more segments increased in size during follow-up period. In a total of 177 segments, the presence or absence of blood flow in the false lumen and aortic diameter were evaluated on CT during the follow-up period. The factors (gender, diabetes mellitus, atherosclerotic disease, smoking, entry site in arch, initial diameter, chronic obstructive pulmonary disease, blood pressure, and age) influencing increase in the diameter and growth rate were also evaluated. Of 177 segments, 132 segments (74.6%) increased in size during the follow-up period. The presence of blood flow in the false lumen was the only significant risk factor for increase in the diameter in the univariate and multivariate analysis. The group with blood flow in the false lumen had a significantly higher mean growth rate (3.3 mm/year) than the group without blood flow (Ϫ1.4 mm/year) (PϽ0.0001). The growth rate of aortic dissections in thoracic aorta and abdominal aorta were 4.1 and 1.2 mm/year, respectively. There was a significant difference in the growth rate between the 2 groups (Pϭ0.0003). Conclusion-In type B aortic dissection, the affected aortas have shown a high incidence of enlargement during the follow-up period, and more careful follow-up study is needed for aortic dissections in the thoracic aorta. The presence of blood flow in the false lumen is the most important risk factor for aortic enlargement.

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Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Growth Rate of Aortic Diameter in Patients With Type B Aortic Dissection During the Chronic Phase

Sueyoshi

Sakamoto²,

Hayashi³

et al. 2004

Circulation

160

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“…In fact, the risk of rupture increases by a factor of nearly 2 for each additional centimeter of thoracoabdominal aneurysmal growth. 32,33 A history of smoking is strongly associated with the development of thoracic and abdominal aortic aneurysms and is a strong predictor for aneurysmal rupture, likely secondary to the destructive effects of tobacco use on connective tissue. 34 Not surprisingly, a clear link between COPD and aneurysmal rupture also exists.…”

Section: Aortic Dissectionmentioning

confidence: 99%

Acute Aortic Syndromes and Thoracic Aortic Aneurysm

Ramanath

Sundt

et al. 2009

Mayo Clinic Proceedings

195

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Acute and chronic aortic diseases have been diagnosed and studied by physicians for centuries. Both the diagnosis and treatment of aortic diseases have been steadily improving over time, largely because of increased physician awareness and improvements in diagnostic modalities. This comprehensive review discusses the pathophysiology and risk factors, classification schemes, epidemiology, clinical presentations, diagnostic modalities, management options, and outcomes of various aortic conditions, including acute aortic dissection (and its variants intramural hematoma and penetrating aortic ulcers) and thoracic aortic aneurysms. Literature searches of the PubMed database were conducted using the following keywords: aortic dissection, intramural hematoma, aortic ulcer, and thoracic aortic aneurysm. Retrospective and prospective studies performed within the past 20 years were included in the review; however, most data are from the past 15 years. and studied by physicians for centuries. Descriptions of such pathologic conditions of the aorta as aneurysm and dissection date back as early as the 2nd century during the time of Galen, whose discoveries were largely made through studies of apes. More "recent" reports were described by Vesalius in 1557, followed by Nichols in 1732, who detailed the process of aortic dissection. In 1761, Morgagni reported detailed pathologic features of a patient with a ruptured aorta. 1 However, our true understanding of aortic pathology began with the dissertation by Shennan 2 in 1934, which included a description of penetrating atheromatous plaques of the thoracic aorta. His report was followed by the first successful management of aortic dissection by DeBakey in 1955. 1 Since then, our knowledge of the pathologic conditions of the aorta has grown considerably and continues to evolve with ongoing research into the pathophysiology of these conditions, technological advances in the modes of detection, and improved therapeutic options. Clinical databases, such as the International Registry of Acute Aortic Dissection (IRAD), the largest current registry for acute aortic syndromes, have also contributed tremendously to our knowledge of acute aortic pathology.For the practicing clinician, knowledge of aortic disease is paramount because patients with aortic conditions contribute significantly to the overall mortality from cardiovascular disease. This review discusses the pathophysiology, epidemiology, presentation, diagnosis, and therapeutic options for several forms of acute and chronic aortic pathology: aortic dissection (including its variants intramural hematoma [IMH] and penetrating atheromatous aortic ulcer) and thoracic aortic aneurysm (TAA). Literature searches were performed of the PubMed database using the following key words: aortic dissection, intramural hematoma, aortic ulcer, and thoracic aortic aneurysm. Retrospective and prospective studies conducted within the past 15 years, along with some data from years prior, were included in this review.

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