[Medical treatment of type III dissecting aortic aneurysms: influence of the shape of the false lumen assessed by X-ray CT as a factor in the long-term prognosis].

The future needs of surgical repair for type III dissecting aneurysms among medically-treated patients were estimated according to the influence of the shapes of false lumina assessed by contrast-enhanced CT scans and by the level of blood pressure control at the time of discharge on the long-term prognoses. Thirty-six patients, 30 males and six females, whose mean age was 61 years, underwent enhanced CT scans at their discharge. Events, including deaths and dissection-related surgery were analyzed by a nonparametric actuarial method of Kaplan and Meier. The changes in CT findings were also studied in 33 patients who underwent follow-up CT scans within a mean interval of 3.5 years. 1. Systolic blood pressure was maintained below 140 mmHg (good control group) in 15 patients, and above 140 mmHg (poor control group) in 18 controls. There were no significant differences between the two groups for event-free survival rates. 2. The shapes of false lumina assessed by enhanced CT scans at the time of discharge were categorized in three types; 21 patients (group A) without false lumina of the aorta, or with a small crescentic false lumen in the thoracic aorta (type a), six patients (group B) with intimal flaps and two contrast-material-filled lumina in the thoracic aorta (type b), and nine patients (group C) with expanded false lumina or a false lumen whose margin was convex towards a true lumen in the thoracic aorta (type c).(ABSTRACT TRUNCATED AT 250 WORDS)