{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T17:40:50Z","timestamp":1789926050651,"version":"4.0.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T00:00:00Z","timestamp":1673222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"\n Objectives<\/jats:title>\n Computed tomography (CT) has been increasingly used in the diagnosis of acute aortic syndrome, and a number of high-risk CT imaging features have been reported. We aimed to identify CT imaging findings suggesting high-risk for acute aortic syndrome by examining clinical outcomes of patients with acute type A aortic intramural hematoma (TAIMH).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective study analyzed the relationship of clinical patient characteristics and imaging features with mortality and aortic events in 63 patients receiving initial medical treatment for TAIMH. Multivariate regression analysis was used to determine the predictors of aortic events, and the Kaplan\u2013Meier method was used to analyze survival and aortic events.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n During a median follow-up of 4.2 years, 25 patients experienced aortic events and 40% of these occurred within 7 days of admission. In total, 12 patients experienced aortic death and 12 patients underwent open aortic surgery or endovascular stenting for aortic disease. In multivariate regression analysis, penetrating atherosclerotic ulcers (PAUs) or ulcer-like projections (ULPs) (\n P<\/jats:italic>\n = 0.04) and pericardial effusion (\n P<\/jats:italic>\n = 0.03) were independent predictors of aortic events. In the Cox regression model, PAUs\/ULPs (\n P<\/jats:italic>\n = 0.04) and pericardial effusion (\n P<\/jats:italic>\n = 0.04) were independently associated with lower aortic event-free survival.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Identification of high-risk CT features is important for clinical decision-making during TAIMH treatment. Early and frequent CT imaging follow-up is required in patients receiving medical treatment. PAUs\/ULP and pericardial effusion were the strongest predictors of adverse aortic events.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fcvm.2022.1041796","type":"journal-article","created":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T02:52:35Z","timestamp":1673232755000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["CT characteristics and clinical implications of acute type A aortic intramural hematoma"],"prefix":"10.3389","volume":"9","author":[{"given":"Hsu-Ting","family":"Yen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Chen","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Wei","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien-Ming","family":"Lo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Yu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2046","DOI":"10.1161\/circulationaha.109.879783","article-title":"Outcomes of patients with acute type a aortic intramural hematoma.","volume":"120","author":"Song","year":"2009","journal-title":"Circulation."},{"key":"B2","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1093\/icvts\/ivz222","article-title":"Natural courses and long-term results of type a acute aortic intramural haematoma and retrograde thrombosed type a acute aortic dissection: a single-centre experience.","volume":"30","author":"Chen","year":"2020","journal-title":"Interact Cardiovasc Thorac Surg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"S91","DOI":"10.1161\/circulationaha.111.084541","article-title":"Acute aortic intramural hematoma: an analysis from the international registry of acute aortic dissection.","volume":"126","author":"Harris","year":"2012","journal-title":"Circulation."},{"key":"B4","doi-asserted-by":"publisher","first-page":"I248","DOI":"10.1161\/01.cir.0000032897.55215.e9","article-title":"Long-term prognosis of patients with type a aortic intramural hematoma.","volume":"106","author":"Kaji","year":"2002","journal-title":"Circulation."},{"key":"B5","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1016\/j.jtcvs.2021.04.053","article-title":"2021 the American association for thoracic surgery expert consensus document: surgical treatment of acute type a aortic dissection.","volume":"162","author":"Malaisrie","year":"2021","journal-title":"J Thorac Cardiovasc Surg."},{"key":"B6","doi-asserted-by":"publisher","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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