Patterns of Visceral and Renal Artery Involvement in Type B Aortic Dissections

Abstract

The main objective of this study was to describe the visceral and renal vessel involvement and the outcomes in thoracic dissections. Computed tomography scans of 39 patients were reviewed (30 type B, 9 type A). Visceral and renal arteries were recorded as perfused by the true lumen (TL) or false lumen (FL). Radiologic follow-up was 3.3 years (range 0-10). A total of 156 vessels were analyzed, and 49 (31%) were supplied by the FL. The most common patterns were FL supply of a renal artery (RA) with the visceral arteries and contralateral RA from the TL. In the follow-up, branch vessel compromise occurred in 12 vessels and was more likely to occur when supplied by the FL (P = .01). About 75% of the patients with at least 2 vessels supplied by the FL demonstrated aortic dilatation. Branch vessel occlusion is more likely in the vessels supplied by the FL. Aortic dilatation occurred more frequently when 2 or more vessels were supplied by the FL.