Evidence map›Paper›PMID 39222827›Full record

ArticleJournal of vascular surgery2025

Early three-dimensional growth in uncomplicated type B aortic dissection is associated with long-term outcomes.

Prabhvir S Marway, Carlos Alberto Campello Jorge, Nicasius Tjahjadi, Timothy J Baker, Gabriel Mistelbauer, Kathrin Baeumler, Virginia Hinostroza, Kai Higashigaito, Domenico Mastrodicasa, Maria Masotti and 4 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of vascular surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Distal anastomotic new entry tears predict long-term outcomes after hemi-arch repair for DeBakey I aortic dissection†.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025
    Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Prabhvir S MarwayDepartment of Radiology, University of Michigan, Ann Arbor, MI.
Carlos Alberto Campello JorgeDepartment of Radiology, University of Michigan, Ann Arbor, MI.
Nicasius TjahjadiDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, MI.
Timothy J BakerDepartment of Radiology, University of Michigan, Ann Arbor, MI.
Gabriel MistelbauerDepartment of Radiology, Stanford University, Stanford, CA.
Kathrin BaeumlerDepartment of Radiology, Stanford University, Stanford, CA.
Virginia HinostrozaDepartment of Radiology, Stanford University, Stanford, CA.
Kai HigashigaitoDepartment of Radiology, Stanford University, Stanford, CA.
Domenico MastrodicasaDepartment of Radiology, Stanford University, Stanford, CA; Department of Radiology, University of Washington School of Medicine, Seattle, WA.
Maria MasottiDepartment of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI.
David NordslettenDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, MI; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI.
Himanshu J PatelDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, MI.
Dominik FleischmannDepartment of Radiology, Stanford University, Stanford, CA.
Nicholas S BurrisDepartment of Radiology, University of Michigan, Ann Arbor, MI. Electronic address: nburris@med.umich.edu.

Funding

Non-invasive hemodynamic and biomechanic imaging methods for early risk prediction in aortic dissectionR01HL170059 · NHLBI · UNIVERSITY OF WISCONSIN-MADISON · PI Nicholas Scott Burris, David Alexander Nordsletten · 2023 to 2026
$2.4M
Vascular Deformation Mapping (VDM) for Automated, 3D Assessment of Thoracic Aortic AneurysmR44HL145953 · NHLBI · IMBIO, LLC · PI BURRIS, NICHOLAS SCOTT, HATT, CHARLES R · 2019 to 2022
$1.5M
NHLBI NIH HHS R01 HL170059NHLBI NIH HHS R44 HL145953
6 · The paper itself

Abstract

objectiveLate adverse events (LAEs) are common among initially uncomplicated type B aortic dissection (uTBAD); however, identifying those patients at highest risk of LAEs remains a significant challenge. Early false lumen (FL) growth has been suggested to increase risk, but confident determination of growth is often hampered by error in two-dimensional clinical measurements. Semi-automated three-dimensional (3D) mapping of aortic growth, such as by vascular deformation mapping (VDM), can potentially overcome this limitation using computed tomography angiograms (CTA). We hypothesized that FL growth in the early pre-dissection phase by VDM can accurately predict LAEs.

methodsWe performed a two-center retrospective study of patients with uTBAD, with paired CTAs in the acute (1-14 days) and subacute/early chronic (1-6 months) periods. VDM analysis was used to map 3D growth. Standard clinical CT measures (ie, aortic diameters, tear characteristics) were also collected. Multivariate analysis was conducted using a decision tree and Cox proportional hazards model. LAEs were defined as aneurysmal FL (>55 mm); rapid growth (>5 mm within 6 months); aorta-specific mortality, rupture, or re-dissection.

resultsA total of 107 (69% male) patients with uTBAD initially met inclusion criteria with a median follow-up of 7.3 years (interquartile range [IQR], 4.7-9.9 years). LAEs occurred in 72 patients (67%) at 2.5 years (IQR, 0.7-4.8 years) after the initial event. A multivariate decision tree model identified VDM growth (>2.1 mm) and baseline diameter (>42.7 mm) as optimal predictors of LAEs (area under the receiver operating characteristic curve = 0.94), achieving an 87% accuracy (sensitivity of 93%, specificity of 76%) after leave-one-out validation. Guideline reported high-risk features were not significantly different between groups.

conclusionsEarly growth of the FL in uTBAD was the best tested indicator for LAEs and improves upon the current gold-standard of baseline diameter in selecting patients for early prophylactic thoracic endovascular aortic repair.

Indexed as

Aortic DissectionComputed Tomography AngiographyImaging, Three-DimensionalPredictive Value of TestsAgedAorta, ThoracicAortic Aneurysm, ThoracicAortographyDisease ProgressionFemaleHumansMaleMiddle AgedRadiographic Image Interpretation, Computer-AssistedRetrospective StudiesRisk AssessmentAdverse eventsAortic diameterAortic growthThoracic endovascular aortic repair (TEVAR)Type B aortic dissection (TBAD)Vascular deformation mapping (VDM)

Identifiers

PMID39222827
PMCPMC13108583

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.