Background
Stanford type A acute aortic dissection (TAAAD) is often accompanied by preoperative
disorders of coagulation. The study aimed to evaluate the relationship between computed
tomography angiography imaging features and preoperative coagulopathy in TAAAD patients.
Methods
This was a single-center retrospective review of adult patients undergoing TAAAD surgery
from January 2015 to January 2019 in the Beijing Anzhen Hospital (Beijing, China).
Images were obtained using preoperative enhanced computed tomography in 174 patients
with TAAAD. Preoperative coagulopathy was defined as the disseminated intravascular
coagulation score greater than 5. The patients were divided into coagulopathy and
non-coagulopathy groups. Circumferential arc lengths of the false lumen (Fx) and true
lumen (Tx) were measured at four planes (ascending aorta, thoracic-descending aorta,
descending aorta and abdominal aorta). We define the value of Fx/(Tx+Fx) × 100% as
tear index (TI) and take the four planes' averages to weighed the false lumen's size.
By analyzing the two groups of clinical data and computed tomography angiography imaging
data, potentially related factors were detected by univariate analysis and multivariate
binary logistic regression analysis.
Results
The incidence of preoperative coagulopathy for TAAAD patients was 12.07%. In adjusted
multivariate binary logistic regression analysis, white blood cell count (odds ratio
[OR]: 1.204, 95% confidence interval [CI]: 1.035–1.400, P = 0.016); longitude length of aortic dissection (OR: 1.076, 95% CI: 1.016–1.139,
P = 0.012); and Tear index (OR = 1.177, 95% CI: 1.075–1.289, P < 0.001) were significant factors related to the occurrence of preoperative coagulopathy
for TAAAD.
Conclusions
The incidence of preoperative coagulopathy in TAAAD patients was 12.07%. The longitude
length of AD, TI and white blood cell count were significant factors related to preoperative
coagulopathy in patients with TAAAD. The significance of imaging and anatomic changes
related to coagulopathy are worth further study in TAAAD patients.
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Article Info
Publication History
Published online: December 18, 2021
Accepted:
November 28,
2021
Received in revised form:
November 18,
2021
Received:
August 6,
2021
Footnotes
Declaration of Competing Interests: The authors declare no competing interests.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
