Treatment of acute type B intramural hematoma of the aorta

Objective To explore the treatment of acute type B intramural hematoma of the descending aorta.Methods This prospective study included 29 patients of acute type B intramural hematoma of the descending aorta.Thirteen patients with penetrating atherosclerotic ulcer of the aorta,intractable hypertension,or persistent pain were enrolled into endovascular intervention group receiving stentgraft implantation,while the other 16 cases were assigned to medical group receiving hypotensive medical therapy.CT scan was performed at 6th and 12th month and then yearly.Results All cases were followedup from 6 to 89 months,averaging 19.28 months.Among the 16 patients with medical therapy,3 progressed to type B aortic dissection and received stent-graft therapy,and the other 2 suffered from aortic rupture and died.The 13 patients in endovascular group with stent-graft implantation recovered smoothly with no complication nor mortality.A total of 16 endografts were used.Conclusions Acute type B intramural hematoma of the descending aorta is a potentially lethal disease,and endovascular stent-graft implantation is an effective option for the treatment. Key words: Aneurysm,dissecting; Stents; Aorta; Intramural hematoma