ArticleGeneral thoracic and cardiovascular surgery2024
Watch-and-wait strategy for selected patients with type A intramural hematoma.
Article in General thoracic and cardiovascular surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 4 citations in OpenAlex.
- Clinical outcomes of conservative management for acute Stanford type A intramural hematoma: a multicenter retrospective study.Heart and vessels · 2026Article
- Early Dynamic Changes in Haematoma Thickness in Medically Managed Type A Intramural Haematoma: A Multicentre Retrospective Study.Interdisciplinary cardiovascular and thoracic surgery · 2026Article
- Article
- Early and Late Surgery-Free Rates of Conservative Management Strategy for Thrombosed Type A Acute Aortic Dissection and Acute Intramural Hematoma.Journal of clinical medicine · 2024Article
- Amplitude at 10 min in thromboelastography predicts maximum amplitude: a single-center observational study.Journal of anesthesia · 2024Observational
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis single-center retrospective study evaluated early and midterm outcomes of 100 consecutive patients with type A intramural hematoma.
methodsInitial watch-and-wait strategy was indicated if the maximum aortic diameter was < 50 mm, pain score was < 3/10 on the numerical rating scale, and no ulcer-like projection was observed in the ascending aorta. The primary endpoints of this study were all-cause and aorta-related deaths, and the secondary endpoint was aortic events.
resultsInitial watch-and-wait strategy was indicated in 52 patients. Emergency aortic repair was indicated in the remaining 48 patients; 2, 31, and 15 patients died before surgery, underwent emergency surgery, and declined emergency surgery, respectively. Among the watch-and-wait group, 11 (21%) patients underwent aortic repair during hospitalization. In-hospital mortality rates, 5-year survival rates, and 5-year freedom from aorta-related death were not significantly different between the initial watch-and-wait strategy and emergency surgery (2% vs. 6%, 92% vs. 82%, and 100% vs. 94%, respectively). In the initial watch-and-wait strategy group, 5-year freedom from aortic events and freedom from aortic events involving the ascending aorta were 60% and 66%, respectively.
conclusionsThe early and midterm outcomes with the initial watch-and-wait strategy in patients with type A intramural hematoma with a maximum aortic diameter of ≤ 50 mm, pain score of ≤ 3/10, and no ulcer-like projection in the ascending aorta were favorable with no aorta-related death.
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