Single-center experience in treatment of Stanford type B aortic intramural hematoma
Objective To evaluate the treatment methods and outcomes for Stanford type B intramural hematoma(IMH).Methods A total of 368 patients with Stanford type B IMH admitted to the Second Affiliated Hospital of Nan-chang University from August 2017 to May 2023 were selected for analysis of their clinical data and treatment outcomes.Results Based on the outcomes during follow-up,the patients were divided into the absorption group(n=134)and the progression group(n=234).Univariate analysis showed significant differences between the absorption and progres-sion groups in terms of age[(60.59±1 1.14)years vs(61.86±12.05)years],platelet count[206.00(88.07)×109/L vs 187.00(86.00)× 109/L],aspartate aminotransferase[18.60(19.37)U/L vs 19.50(7.80)U/L],maximum diameter of the descending aorta[35(6)vs 34(5)mm],and distal hematoma involvement of Zone 6-11[157(66.81％)vs 66(49.25％)](P＜0.05).Multivariate Logistic regression analysis indicated that the maximum diameter of the descending aorta was an independent risk factor for the progression of Stanford type B IMH(OR=0.943,95％CI=0.899-0.990,P=0.017).The average follow-up time for discharged patients was(35.1±17.9)months,with a loss to follow-up rate of 6.8％.The 5-year survival rate post-discharge was 77.4％for the patient with medication treatment and 87.6％for the patient with endovascular treatment.Conclusion Single-center experience suggests that endovascular treatment for Stanford type B IMH is safe and effective.For patients with dilation of the descending aorta,vigilance is required for the progression of intramural hematoma,and surgical intervention may be considered when necessary.
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