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내과적 치료를 받은 대동맥 박리와 대동맥 벽내 혈종 환자들의 자연경과에 관한 다기관 경시적 추적관찰 연구

Other Titles
 Multicenter Longitudinal Follow-up Clinical Study Comparing the Natural Course of Medically-Treated Patients with Aortic Dissection and Aortic Intramural Hematoma 
 송재관  ;  김현숙  ;  송종민  ;  강덕현  ;  하종원  ;  임세중  ;  정남식  ;  김기식  ;  박승우  ;  이두하  ;  김용진  ;  손대원 
 KOREAN CIRCULATION JOURNAL, Vol.31(6) : 592-601, 2001 
Journal Title
Issue Date
Aortic dissection ; Aortic intramural hematoma ; Natural history
Background : Although the same treatment strategy has been applied for patients with aortic intramural hematoma (AIH) as typical aortic dissection (AD), the natural history of AIH with medical treatment is not known clearly. The purposes of this study were to test the hypothesis that absence of direct flow communication through intimal tear in AIH has different impact on clinical course compared with typical AD and to clarify the natural history of AIH. Methods : Total 181 patients of acute aortic pathology (AD/AIH=57/124) were enrolled from 5 institutions. Patients received medical treatment without surgical intervention regardless of the affected site in acute stage, and follow-up imaging studies (FUIS) were performed in 105 patients with AIH. Clinical data of these patients were retrospectively analyzed. Results : Fifty-four patients showed involvement of the ascending aorta (AD/AIH=13/41) and 127 revealed distal pathology (AD/AIH=44/83). Compared to the patients with AD, those with AIH were older regardless of the type and showed higher incidence of pleural effusion and mediastinal hemorrhage. In-hospital mortality of proximal AIH was 7%, which was significantly lower than that of proximal AD (62%) ; mortality of distal AIH was also lower than that of distal AD (1.2 Vs 9%, p<0.05). In proximal AIH, FUIS confirmed resorption of AIH in 67% (24/36) and development of AD in 25% (9/36). In distal AIH, resorption was confirmed in 78% (54/69) and development of AD in 16% (11/69). Conclusions : Patients with AIH showed excellent clinical course and high rate of resorption with medical treatment regardless of the affected site ; typical AD developed only in limited cases. Absence of direct flow communication through intimal tear in AIH might explain more favorable response to medical treatment than typical AD.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Rim, Se Joong(임세중) ORCID logo https://orcid.org/0000-0002-7631-5581
Chung, Nam Sik(정남식)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
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