April 15, 2019Circulation
Impact of Carotid Artery Involvement in Type A Aortic Dissection
Key result
Common carotid artery involvement in acute type A aortic dissection was associated with a significantly higher incidence of preoperative neurological deficit (23% vs 3%; P<0.001).
Why the study?
Common carotid artery dissection and cerebral malperfusion secondary to type A aortic dissection are feared complications with varying incidence and outcome, prompting analysis of their clinical impact.
Does common carotid artery dissection impact clinical characteristics and outcomes in patients surgically treated for acute type A aortic dissection?
Population
1444 patients without Marfan syndrome operated on for acute type A aortic dissection
Comparison
Patients with CCA dissection vs patients with no CCA dissection
Design
Multicenter retrospective registry study
Authors
Discussion
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Member takes
Implication
CCA involvement flags higher neurological risk in ATAAD; extends anatomic risk profiling but leaves open effects on outcomes.
Study Design
Type
Cohort (n=1,444)
Multicenter
Yes
Structured PICO
Does common carotid artery dissection impact clinical characteristics and outcomes in patients surgically treated for acute type A aortic dissection?
P
Population
1,444 patients without Marfan syndrome who underwent surgery for acute type A aortic dissection between 2002 and 2017 across three international centers.
E
Exposure
Presence of common carotid artery (CCA) dissection (unilateral or bilateral)
C
Comparator
No common carotid artery (CCA) dissection
O
Outcome
In-hospital mortality and in-hospital stroke, freedom from stroke during follow-up, and late survivalhard clinical
Main Result
Absolute Event Rate: 23% vs 3%
p-value: p=<0.001
In patients surgically treated for acute type A aortic dissection, common carotid artery involvement is associated with younger age, more frequent preoperative neurological deficits, and more extensive distal aortic dissection.
Cite This Study
Kreibich et al. (2019) conducted a cohort in acute type A aortic dissection (n=1,444). Common carotid artery (CCA) dissection vs. No CCA dissection was evaluated on Preoperative neurological deficit in the absence of hemodynamic compromise (p=<0.001). Common carotid artery involvement in acute type A aortic dissection was associated with a significantly higher incidence of preoperative neurological deficit (23% vs 3%; P<0.001).