Rationale and Objectives
An anatomic association between ductus diverticulum and the primary entry tear in type B aortic dissection was observed. The aim was to reveal the association between ductus diverticulum and acute type B aortic dissection.
Materials and Methods
A matched case-control study was conducted. Case subjects were extracted from consecutive patients with aortic dissection in the emergency department during 2019; the control subjects were extracted from consecutive patients without major aortic disease during 2019. 1:1 matching was performed for age, sex, and comorbidity, the prevalence of ductus diverticulum was compared, and conditional logistic regression was performed to reveal the association of ductus diverticulum and acute type B aortic dissection. In addition, the anatomic association between the ductus diverticulum and the primary entry tear was assessed in extracted cases, and baseline parameters were compared between dissection patients with or without ductus diverticulum.
128 cases and 402 control subjects were extracted. 86 pairs were formed after matching, and the proportion of ductus diverticulum (19.8% vs 1.2%, p < 0.001) was higher in the case group. Conditional logistic regression revealed ductus diverticulum(OR = 22.04, 95%CI: 2.81–172.76, p = 0.003) as an independent predictor for acute type B aortic dissection. Besides, the ductus diverticulum has an anatomic association with the primary entry tear (OR = 4.22, 95%CI: 1.46–12.25, p = 0.008), and dissection patients with ductus diverticulum were younger (47.9 vs 54.4, p = 0.015) than dissection patients without ductus diverticulum.
Ductus diverticulum is common in acute type B aortic dissection and is independently associated with acute type B aortic dissection.
Abbreviations:AD (aortic dissection), CAD (coronary artery disease), CTA (computed tomography angiography), TBAD (type B aortic dissection)
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Academic Radiology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- The IRAD classification system for characterizing survival after aortic dissection.Am J Med. 2013; 126: 730.e19-730.e24https://doi.org/10.1016/j.amjmed.2013.01.020
- Insights from the international registry of acute aortic dissection: a 20-year experience of collaborative clinical research.Circulation. 2018; 137: 1846-1860https://doi.org/10.1161/circulationaha.117.031264
- A systematic review and meta-analysis of the incidence of acute aortic dissections in population-based studies.J Vasc Surg. 2022; 75: 709-720https://doi.org/10.1016/j.jvs.2021.08.080
- Association of family history with incidence and outcomes of aortic dissection.J Am Coll Cardiol. 2020; 76: 1181-1192https://doi.org/10.1016/j.jacc.2020.07.028
- Aortic dissection extending from ductus diverticulum aneurysm.Jpn J Thorac Cardiovasc Surg. 1998; 46: 595-598https://doi.org/10.1007/bf03217786
- Dissection from ductus diverticulum presenting as type A intramural hematoma.Asian Cardiovasc Thorac Ann. 2014; 22: 107https://doi.org/10.1177/0218492312466860
- Society for Vascular Surgery (SVS) and Society of Thoracic Surgeons (STS) reporting standards for Type B aortic dissections.Ann Thorac Surg. 2020; 109: 959-981https://doi.org/10.1016/j.athoracsur.2019.10.005
- The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies.Int J Surg. 2014; 12: 1495-1499https://doi.org/10.1016/j.ijsu.2014.07.013
- Blood pressure, hypertension, and the risk of aortic dissection incidence and mortality: results from the J-SCH study, the UK biobank study, and a meta-analysis of cohort studies.Circulation. 2022; 145: 633-644https://doi.org/10.1161/circulationaha.121.056546
- Low ambient temperature and temperature drop between neighbouring days and acute aortic dissection: a case-crossover study.Eur Heart J. 2022; 43: 228-235https://doi.org/10.1093/eurheartj/ehab803
- Low temperature and temperature decline increase acute aortic dissection risk and burden: a nationwide case crossover analysis at hourly level among 40,270 patients.Lancet Reg Health Western Pac. 2022; 28100562https://doi.org/10.1016/j.lanwpc.2022.100562
- 2014 ESC guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The task force for the diagnosis and treatment of aortic diseases of the European Society of Cardiology (ESC).Eur Heart J. 2014; 35: 2873-2926https://doi.org/10.1093/eurheartj/ehu281
- Current options and recommendations for the treatment of thoracic aortic pathologies involving the aortic arch: an expert consensus document of the European Association for Cardio-Thoracic surgery (EACTS) and the European Society for Vascular Surgery (ESVS).Eur J Cardiothorac Surg. 2019; 55: 133-162https://doi.org/10.1093/ejcts/ezy313
- Current options and recommendations for the use of thoracic endovascular aortic repair in acute and chronic thoracic aortic disease: an expert consensus document of the European Society for Cardiology (ESC) Working Group of Cardiovascular Surgery, the ESC working group on aorta and peripheral vascular diseases, the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC and the European Association for Cardio-Thoracic Surgery (EACTS).Eur J Cardiothorac Surg. 2021; 59: 65-73https://doi.org/10.1093/ejcts/ezaa268
- Echocardiography in adult patients with PDA: a simplified approach.Echocardiography. 2020; 37: 2194-2198https://doi.org/10.1111/echo.14960
- Angiographic evaluation of the ductus diverticulum.Cardiovasc Interv Radiol. 1982; 5: 1-4https://doi.org/10.1007/bf02552093
Published online: February 06, 2023
Accepted: January 13, 2023
Received in revised form: January 10, 2023
Received: December 6, 2022
Publication stageIn Press Corrected Proof
© 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.