The prospective cohort study was reported in line with Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) (4 (link)). The study was approved by the Institutional Review Board (KY-Q-2021-073-01), with informed consent not required due to its observational nature.
All consecutive patients admitted to the Guangdong Provincial People’s Hospital (Guangdong, China) from January 2016 to April 2021 were enrolled and followed up prospectively. Anthropometric, radiologic, laboratory, and operative data were manually accrued from individual electronic medical records and hospital charts. If there were missing values, we would check with the patient or relatives by phone. Computed Tomography Angiography (CTA) was used to confirm IAAD, demonstrating dissected intimal flap and double-lumen aorta below the diaphragm, with or without visible entry tear. Hypertension was diagnosed according to medical history as blood pressure measured at 140/90 mmHg or higher. Diameter was measured perpendicular to the centerline at the different levels in an outer-to-outer manner, and the maximum was noted. The thrombosis status of false lumen was classified as complete thrombosis (CT), partial thrombosis (PT, concurrent presence of both flow and thrombus), and patency (P) proposed by Tsai et al. (5 (link)). Accidental identification of IAAD indicated that the disease was diagnosed by chance such as routinely physical examination or undergoing imaging not specifically for aortic disease. Those patients usually had no symptoms and the aortic dissection was in chronic phase (6 (link)).
There was a lack of recognized protocol for the optimal management of IAAD. Patients were treated either conservatively with best medical therapy (BMT), or aggressively with OS or EVAR, based on attending surgeon’s judgment and patients’ preference. All-cause death was taken as the primary endpoint and surgical intervention for BMT cohort as the secondary endpoint. Patients were followed up either with clinical visits or phone calls.
All consecutive patients admitted to the Guangdong Provincial People’s Hospital (Guangdong, China) from January 2016 to April 2021 were enrolled and followed up prospectively. Anthropometric, radiologic, laboratory, and operative data were manually accrued from individual electronic medical records and hospital charts. If there were missing values, we would check with the patient or relatives by phone. Computed Tomography Angiography (CTA) was used to confirm IAAD, demonstrating dissected intimal flap and double-lumen aorta below the diaphragm, with or without visible entry tear. Hypertension was diagnosed according to medical history as blood pressure measured at 140/90 mmHg or higher. Diameter was measured perpendicular to the centerline at the different levels in an outer-to-outer manner, and the maximum was noted. The thrombosis status of false lumen was classified as complete thrombosis (CT), partial thrombosis (PT, concurrent presence of both flow and thrombus), and patency (P) proposed by Tsai et al. (5 (link)). Accidental identification of IAAD indicated that the disease was diagnosed by chance such as routinely physical examination or undergoing imaging not specifically for aortic disease. Those patients usually had no symptoms and the aortic dissection was in chronic phase (6 (link)).
There was a lack of recognized protocol for the optimal management of IAAD. Patients were treated either conservatively with best medical therapy (BMT), or aggressively with OS or EVAR, based on attending surgeon’s judgment and patients’ preference. All-cause death was taken as the primary endpoint and surgical intervention for BMT cohort as the secondary endpoint. Patients were followed up either with clinical visits or phone calls.
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