{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T07:48:15Z","timestamp":1782978495273,"version":"3.54.5"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T00:00:00Z","timestamp":1782604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T00:00:00Z","timestamp":1782604800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Intramural hematoma (IMH) is characterized by an unpredictable natural history. Thoracic endovascular aortic repair (TEVAR) has increasingly been employed as treatment with limited midterm outcomes reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>To better characterize the natural history of type B IMH and TEVAR outcomes, we reviewed our institutional experience. Data were collected prospectively, and patients followed in a dedicated aortic clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Since 2001, 40 patients were treated for type B IMH without focal intimal disruption (FID) on initial computed tomography (CT). All patients were initially treated with optimal blood pressure management, pain control, and control CT within 5 to 7 days. Fourteen patients had TEVAR during the index hospitalization due to the presence of a new FID with progression of the IMH thickness or persistent symptoms. Of the remaining 26 patients, 16 required late TEVAR at a mean of 41.3 \u00b1 112.2 months for type B dissection, new FID, or pseudoaneurysm formation. The remaining 10 patients had complete resolution of the IMH on optimal medical therapy (OMT) alone. Patients in the early TEVAR group developed a significantly higher rate of complication than patients treated in the chronic TEVAR phase (78% vs 38%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003). Patients treated with early and late TEVAR had a 5-year survival of 100% and 64.9%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Impact<\/jats:title>\n                    <jats:p>Favorable outcomes can be achieved with OMT and TEVAR for patients with type B IMH. The TEVAR performed in the acute setting carries a substantial risk of complications, emphasizing the need to optimize the timing of TEVAR and adapt stent-graft design to the pathophysiology of IMH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15266028261458174","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T06:15:17Z","timestamp":1782713717000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Natural History and Impact of Thoracic Endovascular Stent-Grafting on Type B Intramural Hematoma: A World of Caution"],"prefix":"10.1177","author":[{"given":"Charles","family":"Laurin","sequence":"first","affiliation":[{"name":"Cardiac Surgery Department, Quebec Heart and Lung Institute, Universit\u00e9 Laval, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6198-7769","authenticated-orcid":false,"given":"Philippe","family":"Chass\u00e9","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Quebec Heart and Lung Institute, Universit\u00e9 Laval, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Santoire","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Quebec Heart and Lung Institute, Universit\u00e9 Laval, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Porterie","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Quebec Heart and Lung Institute, Universit\u00e9 Laval, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rim","family":"Abdelli","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Quebec Heart and Lung Institute, Universit\u00e9 Laval, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Dagenais","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Quebec Heart and Lung Institute, Universit\u00e9 Laval, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,28]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.03.155"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz153"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.21037\/acs.2019.06.11"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2021.09.045"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2018.03.010"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.21037\/acs.2019.04.09"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2022.07.009"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00380-020-01583-3"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.11.015"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021204385"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-019-06254-0"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2011.04.055"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezab249"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.07.111"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2023.08.014"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2023.12.024"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2025.02.002"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12350-017-1014-9"}],"container-title":["Journal 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