none15siopenLettinga, Mark; Patel, Himanshu; Peterson, Mark; Ehrlich, Marek; Myrmel, Truls; Conklin, Lori; Mussa, Firas; Bavaria, Joseph; Gleason, Thomas; Di Eusanio, Marco; Montgomery, Daniel; Eagle, Kim; Isselbacher, Eric; Nienaber, Christoph; Trimarchi, SantiLettinga, Mark; Patel, Himanshu; Peterson, Mark; Ehrlich, Marek; Myrmel, Truls; Conklin, Lori; Mussa, Firas; Bavaria, Joseph; Gleason, Thomas; Di Eusanio, Marco; Montgomery, Daniel; Eagle, Kim; Isselbacher, Eric; Nienaber, Christoph; Trimarchi, Sant

Bavaria, Joseph

Conklin, Lori

Di Eusanio, Marco

Eagle, Kim

Ehrlich, Marek

Gleason, Thomas

Isselbacher, Eric

Lettinga, Mark

Montgomery, Daniel

Mussa, Firas

Myrmel, Truls

Nienaber, Christoph

Patel, Himanshu

Peterson, Mark

Trimarchi, Santi

English

Elsevier - Publisher Connector 

Vascular Medicine
A2063
JACC April 1, 2014
Volume 63, Issue 12
predictors oF subsequent intervention AFter initiAl treAtment For Acute Aortic 
dissection
Poster Contributions
Hall C
Saturday, March 29, 2014, 10:00 a.m.-10:45 a.m.
Session Title: Aortic and Peripheral Artery Dissections
Abstract Category: 32. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1105-79
Authors: Mark Lettinga, Himanshu Patel, Mark Peterson, Marek Ehrlich, Truls Myrmel, Lori Conklin, Firas Mussa, Joseph Bavaria, Thomas Gleason, 
Marco Di Eusanio, Daniel Montgomery, Kim Eagle, Eric Isselbacher, Christoph Nienaber, Santi Trimarchi, University of Michigan Health System, 
Ann Arbor, MI, USA, Michigan Clinical Outcomes Research and Reporting Program, Ann Arbor, MI, USA
purpose: Follow-up interventions are a common complication of acute aortic dissection (AAD), with published rates of additional procedures 
between 7.8%-23.2%.
methods: This study analyzed 931 patients enrolled in the International Registry of Acute Aortic Dissection with available follow-up data (median 
1.0 years (1.0-3.0)) who were categorized by AAD type and whether they received a late intervention, defined as a post-discharge surgical or 
endovascular aortic procedure.
results: Type A (TA) AAD patients with late intervention were younger (53.7±14.6 vs. 59.7±14.2, p=0.005) and more often had Marfan syndrome 
(MFS) (19.6% vs. 3.0%, p<0.001) and prior cardiac intervention at initial presentation (20.5% vs. 7.0%, p=0.006). Type B (TB) patients with 
late procedures were also younger (55.6±13.4 vs. 63.9±12.9, p<0.001) and had more MFS (11.3% vs. 1.1%, p<0.001) and more cocaine use 
documented at initial presentation (7.3% v. 1.8%, p=0.005). No patients with dissection limited to the ascending aorta received late intervention. 
On follow-up, recurrence of pain (54.8% vs. 21.3% TA, 47.4% vs 24.6% TB), new aneurysm (30.2% vs. 7.4% TA, 36.5% vs. 10.8% TB), and/or 
progression of dissection (44.7% vs 7.0% TA, 24.2% vs. 5.9% TB) were associated with late intervention (p<0.001 for all unless noted).
conclusions: Kaplan Meier estimates of freedom from late intervention were 86.6% in TA patients and 69.0% in TB patients (p<0.001). Younger 
patients and those with Marfan syndrome had more subsequent reintervention.


PREDICTORS OF SUBSEQUENT INTERVENTION AFTER INITIAL TREATMENT FOR ACUTE AORTIC DISSECTION 

IRIS UniversitÃ  Politecnica delle Marche

Vascular MedicineA2063JACC April 1, 2014Volume 63, Issue 12predictors oF subsequent intervention AFter initiAl treAtment For Acute Aortic dissectionPoster ContributionsHall CSaturday, March 29, 2014, 10:00 a.m.-10:45 a.m.Session Title: Aortic and Peripheral Artery DissectionsAbstract Category: 32. Vascular Medicine: Non Coronary Arterial DiseasePresentation Number: 1105-79Authors: Mark Lettinga, Himanshu Patel, Mark Peterson, Marek Ehrlich, Truls Myrmel, Lori Conklin, Firas Mussa, Joseph Bavaria, Thomas Gleason, Marco Di Eusanio, Daniel Montgomery, Kim Eagle, Eric Isselbacher, Christoph Nienaber, Santi Trimarchi, University of Michigan Health System, Ann Arbor, MI, USA, Michigan Clinical Outcomes Research and Reporting Program, Ann Arbor, MI, USApurpose: Follow-up interventions are a common complication of acute aortic dissection (AAD), with published rates of additional procedures between 7.8%-23.2%.methods: This study analyzed 931 patients enrolled in the International Registry of Acute Aortic Dissection with available follow-up data (median 1.0 years (1.0-3.0)) who were categorized by AAD type and whether they received a late intervention, defined as a post-discharge surgical or endovascular aortic procedure.results: Type A (TA) AAD patients with late intervention were younger (53.7±14.6 vs. 59.7±14.2, p=0.005) and more often had Marfan syndrome (MFS) (19.6% vs. 3.0%, p<0.001) and prior cardiac intervention at initial presentation (20.5% vs. 7.0%, p=0.006). Type B (TB) patients with late procedures were also younger (55.6±13.4 vs. 63.9±12.9, p<0.001) and had more MFS (11.3% vs. 1.1%, p<0.001) and more cocaine use documented at initial presentation (7.3% v. 1.8%, p=0.005). No patients with dissection limited to the ascending aorta received late intervention. On follow-up, recurrence of pain (54.8% vs. 21.3% TA, 47.4% vs 24.6% TB), new aneurysm (30.2% vs. 7.4% TA, 36.5% vs. 10.8% TB), and/or progression of dissection (44.7% vs 7.0% TA, 24.2% vs. 5.9% TB) were associated with late intervention (p<0.001 for all unless noted).conclusions: Kaplan Meier estimates of freedom from late intervention were 86.6% in TA patients and 69.0% in TB patients (p<0.001). Younger patients and those with Marfan syndrome had more subsequent reintervention.

PREDICTORS OF SUBSEQUENT INTERVENTION AFTER INITIAL TREATMENT FOR ACUTE AORTIC DISSECTION

https://iris.univpm.it/bitstream/11566/262877/1/Predictors%20of%20Subsequent%20Intervention%20after%20Initial%20Treatment%20for%20Acute%20Aortic.pdf

PREDICTORS OF SUBSEQUENT INTERVENTION AFTER INITIAL TREATMENT FOR ACUTE AORTIC DISSECTION

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