Clinical Analysis of 19 Patients with Aortic Intramural Hematoma

HOU Yun-sheng; WANG Wen-xia; XIA Wei; JIA LI-jun; WANG ZHI-gang

doi:10.3969/j.issn.1002-3429.2017.02.020

Abstract：Objective To summarize clinical characteristics and measures of diagnosis and treatment for aortic intra-mural hematoma. Methods Clinical data of 19 aortic intramural hematoma patients who had been confirmed by spiral en-hancement CT was retrospectively analyzed. Results The rate of 19 aortic intramural hematoma patients had accounted for 18. 10% of acute aortic syndrome (AAS) patients during the same period, and male female ratio was 5. 3: 1. 0. Age of onset was (60. 58 ± 7. 33) years old. There were 16 patients having a history of hypertension, 5 patients having a history of diabetes mellitus and 10 patients combined with coronary heart disease. Initial symptoms were acute thoracodorsal pain in 18 patients and acute abdominal pain in 1 patient. All the 19 patients were confirmed by CTA. There were 4 patients with Stanford A and 15 patients with Stanford B. One patient with Stanford A had undergone surgery after admission, and second patient with Stan-ford A had left at his free will, while the rest patients had been treated with medicine after admission, In whom 2 patients with Stanford B had been treated with intra-aortic stent insertion. The 18 inpatients were discharged after condition improvement by treatment. A total of 14 patients were followed up after discharge, and the average follow-up time was ( 10. 26 ± 4. 13 ) months. Among them 1 Stanford A patient without operation died suddenly 3 months after discharge, while the rest patients had survived. Conclusion Aortic intramural hematoma is a dangerous and fatal disease, and therefore clinicians should im-prove knowledge and pay highly attention so as to avoid misdiagnosis. It is the key to improve prognosis by early diagnosis and individualized treatment.