{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T21:00:50Z","timestamp":1771016450854,"version":"3.50.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T00:00:00Z","timestamp":1664841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Single-center retrospective cohort study to evaluate the impact of oral anticoagulation (OAC) on long-term outcomes of conservatively managed acute type B aortic dissection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Clinical and morphological data of eligible patients from a high-volume vascular centre from 1 January 2003 through 31 December 2020 were evaluated. Patients were excluded for: type A or non-A-non-B dissection, isolated abdominal dissection, intramural haematoma and connective tissue disease. The primary outcome was freedom from late aortic events (intervention, rupture and mortality). Secondary outcomes included spinal cord ischaemia, bleeding, reno-visceral artery occlusion, ilio-femoral intervention, dissection propagation, aortic growth, aortic remodelling, deterioration of false lumen thrombosis as well as 30-day and overall mortality. Time to event was analysed using multivariable Cox proportional hazard models with OAC as time-varying covariate and mortality as a competing risk. The impact of OAC was adjusted for potential confounding factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 69 patients [50 males, median age 65 (interquartile range: 58\u201372) years] were enrolled. The median follow-up was 49.3 (28\u201392) months. A total of 47 patients (68%) received OAC at any time throughout the follow-up for a median length of 26 (11\u201361) months. Late aortic events occurred in 28 patients (41%) including intervention (n\u2009=\u200927, 39%) and rupture (n\u2009=\u20091, 1%). OAC was associated with more late aortic events (hazard ratio 3.94, 95% confidence interval 1.06\u201314.6, P\u2009=\u20090.040). Secondary outcomes were not associated with OAC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Our data suggest a relation of OAC therapy with an increased risk for late aortic interventions. Type B aortic dissection should not be the primary indication for OAC and patients with OAC for other indications require frequent follow-up imaging.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezac495","type":"journal-article","created":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T13:47:31Z","timestamp":1665064051000},"source":"Crossref","is-referenced-by-count":6,"title":["ORal anticoagulation risks late aortic intervention in Conservatively managed type B Aortic dissection (ORCA study)"],"prefix":"10.1093","volume":"62","author":[{"given":"Katarzyna","family":"Jesse","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, University Hospital Zurich , Zurich, Switzerland"},{"name":"Department of Cardiology, University Hospital Zurich , Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7493-2319","authenticated-orcid":false,"given":"Lorenz","family":"Meuli","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital Zurich , Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reinhard","family":"Kopp","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital Zurich , Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9286-8223","authenticated-orcid":false,"given":"Benedikt","family":"Reutersberg","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital Zurich , Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Stadlbauer","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital Zurich , Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0635-8591","authenticated-orcid":false,"given":"Alexander","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital Zurich , Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3741-0591","authenticated-orcid":false,"given":"Philip","family":"Dueppers","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital Zurich , Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,10,6]]},"reference":[{"key":"2022103110274411900_ezac495-B1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1093\/ejcts\/ezaa268","article-title":"Current options and recommendations for the use of thoracic endovascular aortic repair in acute and chronic thoracic aortic disease: an expert consensus document of the European Society for Cardiology (ESC) Working Group of Cardiovascular Surgery, the ESC Working Group on Aorta and Peripheral Vascular Diseases, the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC and the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"59","author":"Czerny","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022103110274411900_ezac495-B2","doi-asserted-by":"crossref","first-page":"e011402","DOI":"10.1161\/JAHA.118.011402","article-title":"Hospital incidence and in-hospital mortality of surgically and interventionally treated aortic dissections: secondary data analysis of the nationwide German Diagnosis-Related Group statistics from 2006 to 2014","volume":"8","author":"Reutersberg","year":"2019","journal-title":"J Am Heart Assoc"},{"key":"2022103110274411900_ezac495-B3","doi-asserted-by":"crossref","first-page":"2873","DOI":"10.1093\/eurheartj\/ehu281","article-title":"2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. 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