{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T03:57:14Z","timestamp":1780718234056,"version":"3.54.1"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1_supplement","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2006,7,4]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background\u2014<\/jats:italic>\n            <\/jats:bold>\n            Currently, the optimal treatment of acute type B aortic dissection remains controversial. The purpose of this study was to report early clinical outcomes of medical management for acute type B aortic dissection.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods and Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            Between January 2001 and March 2005, 129 consecutive patients with the confirmed diagnosis of acute type B aortic dissection were studied. Mean age was 61 years (range, 29 to 94), with 33.3% (43\/129) female. Acute type B aortic dissection protocol was instituted with the intent to manage all patients medically. Indications for surgical intervention included rupture, aortic expansion, malperfusion, and intractable pain. All patients were followed-up after discharge. Hospital mortality was 10.1% (13\/129), 19% (4\/21) when vascular intervention was required, and 8.3% (9\/108) when medical management was maintained. Early intervention was required in 21 cases (16.2%), 19 (14.7%) open vascular\/aortic cases and 2 cases (1.6%) of percutaneous aortic interventions. Morbidity included rupture (4.7%), stroke (4.7%), paraplegia (8.5%), bowel ischemia (7%), acute renal failure (21%), dialysis requirement (13%), and peripheral ischemia (4.7%). Late vascular-related procedures were performed in 5.2% (6\/116) of cases. Univariate risk factors for early mortality were rupture (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.0001), need for laparotomy (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.008), acute renal failure (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.0001), need for dialysis (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.0001), and lower extremity ischemia (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.0004). The only independent risk factors for hospital mortality by multiple logistic regression was rupture (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.0009), and independent risk factors for midterm death were history of chronic obstructive pulmonary disease (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.002) and low glomerular filtration rate (&lt;57 mL\/min;\n            <jats:italic>P<\/jats:italic>\n            &lt;0.0001).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            Medical management for acute type B aortic dissection is associated acceptable outcomes. Outcomes of other management strategies, eg, endovascular stenting, for acute type B aortic dissection need to be compared with these results.\n          <\/jats:p>","DOI":"10.1161\/circulationaha.105.001479","type":"journal-article","created":{"date-parts":[[2006,7,7]],"date-time":"2006-07-07T01:56:58Z","timestamp":1152237418000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":129,"title":["Outcomes of Medical Management of Acute Type B Aortic Dissection"],"prefix":"10.1161","volume":"114","author":[{"given":"Anthony L.","family":"Estrera","sequence":"first","affiliation":[{"name":"From the Department of Cardiothoracic and Vascular Surgery, The University of Texas\u2013Houston Medical School, Memorial Hermann Heart and Vascular Institute, Houston, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Charles C.","family":"Miller","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic and Vascular Surgery, The University of Texas\u2013Houston Medical School, Memorial Hermann Heart and Vascular Institute, Houston, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazim J.","family":"Safi","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic and Vascular Surgery, The University of Texas\u2013Houston Medical School, Memorial Hermann Heart and Vascular Institute, Houston, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S.","family":"Goodrick","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic and Vascular Surgery, The University of Texas\u2013Houston Medical School, Memorial Hermann Heart and Vascular Institute, Houston, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash","family":"Keyhani","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic and Vascular Surgery, The University of Texas\u2013Houston Medical School, Memorial Hermann Heart and Vascular Institute, Houston, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyal E.","family":"Porat","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic and Vascular Surgery, The University of Texas\u2013Houston Medical School, Memorial Hermann Heart and Vascular Institute, Houston, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul E.","family":"Achouh","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic and Vascular Surgery, The University of Texas\u2013Houston Medical School, Memorial Hermann Heart and Vascular Institute, Houston, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riad","family":"Meada","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic and Vascular Surgery, The University of Texas\u2013Houston Medical School, Memorial Hermann Heart and Vascular Institute, Houston, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Azizzadeh","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic and Vascular Surgery, The University of Texas\u2013Houston Medical School, Memorial Hermann Heart and Vascular Institute, Houston, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayesh","family":"Dhareshwar","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic and Vascular Surgery, The University of Texas\u2013Houston Medical School, Memorial Hermann Heart and Vascular Institute, Houston, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan","family":"Allaham","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic and Vascular Surgery, The University of Texas\u2013Houston Medical School, Memorial Hermann Heart and Vascular Institute, Houston, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(16)37884-7"},{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)33192-7"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)65594-4"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.70.2.6234109"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)38102-4"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2002.123131"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000087009.16755.e4"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2004.05.019"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000087386.07204.09"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0741-5214(88)90137-1"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(99)00428-2"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(16)43646-7"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(99)00419-1"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.9.113"},{"key":"e_1_3_3_15_2","first-page":"489","volume":"72","year":"2006","unstructured":"Eggebrecht H, Nienaber CA, Neuhauser M, Baumgart D, Kische S, Schmermund A, Herold U, Rehders TC, Jakob HG, Erbel R. Endovascular stent-graft placement in aortic dissection: a meta-analysis. Eur Heart J. 2006; 72: 489\u2013498.","journal-title":"Eur Heart J"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.100.suppl_2.II-275"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2005.02.021"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2005.05.060"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)00113-9"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2004.07.061"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.105.001479","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T05:01:01Z","timestamp":1715576461000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.105.001479"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,7,4]]},"references-count":20,"journal-issue":{"issue":"1_supplement","published-print":{"date-parts":[[2006,7,4]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.105.001479"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.105.001479","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,7,4]]},"assertion":[{"value":"2006-07-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}