What is type B intramural hematoma?
For high-risk type B IMH patients, defined as a maximum aortic diameter >40–45 mm, PAU, hematoma of >10 mm at the initial presentation, progressive hematoma in 2 successive imaging studies, uncontrollable hypertension and therapy refractory pain, a more aggressive treatment strategy is recommended.
How long can you live with a type B aortic dissection?
Despite adequate antihypertensive therapy, the long-term prognosis of these patients is characterized by a significant aortic aneurysm formation in 25-30% within four years, and survival rates from 50 to 80% at five years and 30 to 60% at 10 years.
What causes aortic dissection type B?
The most important risk factor is increased blood pressure as this result in greater stress against the aortic wall. Other risk factors include atherosclerosis, smoking, pre-existing aneurysm, aortic valve defects and previous surgery on the aorta.
Does Type B aortic dissection require surgery?
Background. Stanford type B aortic dissection is one of the aortic catastrophes with a high mortality and morbidity that needs immediate or delayed treatment, either surgically or endovascularly.
How is an intramural hematoma diagnosed?
Symptoms generally include:
- Severe chest pain.
- Severe back pain.
- Severe abdominal pain.
- Shortness of breath.
- Pain in the arms or legs.
- Loss of consciousness.
- Rapid, weak pulse.
What is type B aortic dissection?
INTRODUCTION Chronic type B aortic dissection is defined as one in which the tear originates in the descending thoracic aorta and which has been present for more than 90 days.
How is type B aortic dissection treated?
Medical management is generally the preferred treatment for uncomplicated type B acute aortic dissection cases. It is often centered on the use of antihypertensive agents, which alleviates hemodynamic stress on the damaged aortic wall.
How do you treat an intramural hematoma?
Treatment usually involves surgery or medication. If the condition occurs in the area of the aorta that is descending into the abdomen, medication may be used to treat it. Medication may also be used to stabilize a patient’s condition before surgery.
How is aortic intramural hematoma Type B treated?
Management strategies in acute type B aortic intramural hematoma Type B IMH should be managed with antiimpulse therapy, unless the patient has persistent pain or large ulcer-like projection. Type B IMH should be managed with antiimpulse therapy, unless the patient has persistent pain or large ulcer-like projection.
What’s the difference between Type B aortic dissection and IMH?
Type B acute aortic dissection (AAD) and intramural hematoma (IMH) can both present as potentially catastrophic lesions of the descending aorta. IMH is distinguished from AAD by the absence of an intimal tear and flap. With short-term outcomes being similar to type B AAD, IMH is treated identically to AAD in the corresponding segment of the aorta.
How are grafts used to treat aortic hematoma?
Surgery will focus on removing the damaged portion of the aorta and placing a graft in place of the removed portion in order to prevent blood from running into the aortic wall. The graft is generally a tube made of synthetic material that helps restore function to the damaged area.
How are blood tests used to diagnose aortic IMH?
Some of the diagnostic imaging tests require a special dye to be injected into the vein so that it shows up more clearly on the images. Other laboratory tests, such as blood tests, are often performed to rule out other conditions such as a heart attack. Because aortic IMH is a life-threatening condition, treatment is usually needed immediately.