Arq. Bras. Cardiol. 2023; 120(8): e20230550
Unfolding Type B Aortic Dissection Controversies – Piecing Together the Evidence
Walter J. Gomes
, Eduardo N. Gomes, Nelson A. Hossne Jr.
This Short Editorial is referred by the Research article "Factors Affecting False Lumen Thrombosis In Type B Aortic Dissection".
Unlike type A aortic dissection, many aspects of the natural history of type B aortic dissection (TBAD) remain blurred and unsettled, leading to uncertainties in its prognosis, recommendations, and management., Among the critical factors impacting TBAD outcomes, the thrombosis of the false lumen seems to be an associated finding exhibiting a robust correlation with late prognosis and conveying significant clinical implications. In addition to being a critical prognostic indicator for TBAD patients, the presence or absence of false lumen thrombosis has been employed to guide treatment decisions, affecting the choice of therapeutic interventions, the thoracic endovascular aortic repair (TEVAR) and adjusting post-treatment follow-up.
In this way, Tang et al. report an interesting aspect of the correlation between imaging and clinics in this issue. Analyzing a large cohort of consecutive patients with TBAD, they investigated the factors affecting false lumen thrombosis in patients with TBAD, focusing on understanding the role of aortic morphology in the thrombosis of the false lumen. Computed tomographic angiography images were used for measurements. Specialized software reconstructed three-dimensional models of aortic dissection, and measurements of true and false lumen diameters were performed at different zones of the aorta. The incidence of thrombotic false lumen was higher in older patients with normal renal function than in younger patients or those with compromised kidney function.
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