YC Chan
Yiu Che Chan, University of Hong Kong Medical Centre, Hong kong
Title: Comparison Study on Ascending Aortic & Arch Characteristics in Patients with Degenerative Arch Aneurysms and Type B Aortic Dissection with Aneurysmal Changes
Biography
Biography: YC Chan
Abstract
Introduction: The aim of this study is to examine the ascending aortic and arch characteristics in a cohort of Chinese patients who had arch and descending aortic pathology, and to compare with a control group of patients who had abdominal aortic pathology without thoracic aortic pathology.
Methods: Prospectively collected computerized database on 3 groups of patients: 1. degenerative arch aneurysms 2. chronic Type B thoracic aortic dissection with aneurysmal changes 3. patients with infrarenal aortic aneurysms. Their computed tomography images were analysed using Aquarius workstation (TeraRecon, San Mateo, USA) and measurements of aortic diameter was measured at intervals from the root , ascending, arch to just proximally to the left subclavian artery. Comparisons were made and statistical analysis was with ANOVA, with a p-value of ≤0.05 taken as statistical significant.
Results: There were 30 patients in each group. Patient in group 1 were older than group 2 (age 771.1+8.6 versus 61.9+14.5, group 3 73.7+10; p<0.001). Maximum sac sizes were larger in group 1 than group 2 (71.7+2.84cm versus 57.7+1.96; p=0.001). Regarding mean diameters at various levels, Group 1 were statistically larger than groups 2 and 3, whilst there were no statistical difference between group 2 and 3 (Table I). For maximum aortic dimensions, the group 1 diameters were near or more than 40mm, whilst group 2 mean diameters were less than 40mm (p<0.01 at all levels) (Table II). Having an arch aneurysm was the only significant predictor of having a mid- or distal-ascending diameter of ≥40mm (Odds ratio 4.57; p=0.007).
Conclusion: This study showed that ascending aortic diameters are often dilated and unhealthy in patients with degenerative arch aneurysms, compared with those with chronic dissections with aneurysmal changes or with infrarenal aortic aneurysms. Such unfavourable anatomical criteria may prevent the applicability of pure endovascular arch repair.