Objectives: To evaluate the effects of thoracic endovascular aortic repair (TEVAR) in descending aorta for retrograde type A aortic intramural hematoma (re-TAIMH). Methods: From January 2013 to September 2019, 65 consecutive patients diagnosed with re-TAIMH and treated by TEVAR were enrolled in this retrospective cohort study, of whom 44 patients presented with entry tear in descending aorta (Group A) and 21 with penetrating atherosclerotic ulcer (Group B). The clinical data, including baseline characteristics, adverse events, aortic remolding, and overall survival were reviewed. Results: The mean age of all the patients was 52.0 ± 8.3 years, and 54 (83.1%) patients were men. The mean maximal ascending aortic diameter (MAAD) was 43.1 ± 5.4 mm, and the mean maximal ascending aortic hematoma thickness (MAAHT) was 9.6 ± 4.7 mm. TEVAR was performed under general anesthesia in 53 (81.5%) patients, while 12 (18.5%) patients were treated under local anesthesia. There were two deaths during hospitalization (one with rupture and another with multiple organ dysfunction syndrome), and overall survival at 1, 4, and 7 years for all 65 patients was 93.8, 92.0, and 87.4%, respectively. The MAAD and MAATH decreased significantly after TEVAR (p < 0.05) in the two groups, so did the mean descending aortic diameter at the pulmonary bifurcation level. Type I endoleak, dialysis, progression to type A aortic dissection, and enlargement in MAAHT and MAAD were more common complications, which occurred in four, three, two, and two patients, respectively. Conclusion: Patients with retrograde TAIMH treated by TEVAR had a favorable prognosis including late survival and aortic remolding. However, some post-intervention complications were not negligible.

中文翻译：

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胸主动脉血管内修复逆行 A 型主动脉壁内血肿。

目的：评估胸主动脉腔内修复术（TEVAR）在降主动脉中对逆行A型主动脉壁内血肿（re-TAIMH）的影响。方法：自2013年1月至2019年9月，连续65例确诊为再TAIMH并接受TEVAR治疗的患者纳入该回顾性队列研究，其中降主动脉入口撕裂44例（A组），穿透性动脉粥样硬化溃疡21例。 （B 组）。回顾了临床数据，包括基线特征、不良事件、主动脉重塑和总生存期。结果：所有患者的平均年龄为 52.0±8.3 岁，54 名（83.1%）患者为男性。平均最大升主动脉直径 (MAAD) 为 43.1 ± 5.4 mm，平均最大升主动脉血肿厚度 (MAAHT) 为 9.6 ± 4.7 mm。53 名（81.5%）患者在全身麻醉下进行 TEVAR，而 12 名（18.5%）患者在局部麻醉下进行治疗。住院期间有 2 例死亡（1 例破裂，1 例多器官功能障碍综合征），所有 65 例患者的 1、4 和 7 年总生存率分别为 93.8%、92.0% 和 87.4%。两组在 TEVAR 后 MAAD 和 MAATH 显着降低（p < 0.05），肺分叉水平的平均降主动脉直径也是如此。I 型内漏、透析、进展为 A 型主动脉夹层以及 MAAHT 和 MAAD 扩大是更常见的并发症，分别发生在 4、3、2 和 2 名患者中。结论：经TEVAR治疗的逆行TAIMH患者预后良好，包括晚期生存和主动脉重塑。