Timing of Intervention and Long-Term Outcomes of Type B Aortic Intramural Hematoma with Intimal Disruption at Admission

Abstract

To compare the 30-day and long-term outcomes between patients with concomitant type B intramural hematoma and intimal disruption upon admission who underwent endovascular repair in the acute or subacute phases. Data were extracted from January 1, 2010, to December 31, 2019. Logistic regression and Cox regression were performed to evaluate the impact of timing of intervention on 30-day and long-term outcomes, respectively. The study included 241 patients, among which 159 were in the acute group. No significant difference was observed in 30-day mortality (0.6% vs. 0%, P=1), 30-day complication rate (2.5% vs. 1.2%, P=0.664), long-term all-cause mortality (10.7% vs. 7.3%, P=0.540), and aortic reintervention rate (2.5% vs. 2.4%, P=1) between the acute and subacute group. In multivariable analysis, the timing of intervention was not associated with 30-day mortality (odds ratio (OR)=0, 95% confidence interval CI: 0-Inf, P=0.999), 30-day complication (OR=0.30, 95% CI: 0.02-3.77, P=0.348), long-term mortality (hazard ratio=0.56, 95% CI: 0.20-1.61, P=0.283), and aortic reintervention (OR=0.97, 95% CI: 0.15-6.08, P=0.970). For patients with concomitant type B intramural hematoma and intimal disruption upon admission, there is no significant difference in 30-day and long-term outcomes between those who undergo endovascular treatment in the acute or subacute phase.