Title:The Location of Vascular Flap is Related with Daily Activity Patterns in Non-traumatic Acute Aortic Syndrome in a Chinese Population
VOLUME: 10 ISSUE: 1
Author(s):Kong Lingjie, Sun Da, An Ting, Liu Jie, Meng Qingyi and Huang Xianyong
Affiliation:Department of Emergency Medicine, Chinese PLA General Hospital, Beijing, 100853, P.R. China.
Keywords:Acute aortic syndrome, acute aortic dissection, aorta, daily activities, diagnosis, flap location, ruptured aortic
aneurysm.
Abstract:Background: Acute aortic syndrome (AAS) is a group of serious and lethal aortic
emergencies, which have so variable and non-specific clinical presentations and can be misdiagnosed
as other diseases. AAS occurs frequently in daily life, but too little attention was paid on the location
of its vascular flap according to different daily activity patterns.
Methods: The data of 160 cases hospitalized for non-traumatic acute aortic syndrome in Chinese PLA general hospital
from January 1st, 2004 to December 31st, 2013 were analyzed retrospectively. Among the 160 patients enrolled, 155
(96.9%, of160) were finally diagnosed with acute aortic dissection (AAD) and the other 5 (3.1%, of 160) with ruptured
aortic aneurysm (RAA). Of those155 patients with AAD, 45 (29.0%, of 155) were definitely diagnosed with type A and
110 (71.0%, of 155) for type B according to the Stanford classification system.
Results: (1) Flaps of aorta in AAS patients were found more commonly located in the thoracic descending aorta (68.1%,
109/160), and the other 24 cases (15.0%, 24/160) in the ascending aorta, 21 cases (21/160, 13.1 %) in aorta arch, and only
6 cases (6/160,3.8%) in the abdominal aorta. (2) There are 65 AAS patients (40.63%) with the body postural changes, 44
(27.50%) for body stretching, 25 (15.63%) for weighting, 17 (10.63%) for pound on the anterior body, 5 (3.13%) for
turning the steering wheel and 4 (2.50%) for cycling during the onset of disease. (3) In the body postural changes group,
the vessel flaps were dominantly found on thoracic descending aorta (76.92%, 50/65), which was significantly higher than
the others (62.11%, 59/95; X2=3.902, P=0.040). (4) In the body stretching group, the vessel flaps on thoracic descending
aorta were frequently (56.82%, 25/44), and on the ascending aorta was 31.82% (14/44), which significantly higher than
the body postural change group (4.63%, 3/65; X2=15.028, P=0.0001) (5) The proportion of aortic arch flaps in the
weighting group was 28.57% (6/21), which was significantly higher than the others (11.11%, 15/135; X2=3.073,
P=0.081). (6) The frequency of the ascending aorta flap location in the pound on the anterior body group was significantly
higher than the other activities (41.18%, 7/17 vs. 11.89%, 17/143; X2=10.222, P=0.001); and the abdominal aorta was
also significantly higher than the other activities (16.65%, 3/17 vs. 20.98%, 3/143; X2=10.178, P=0.001). (7) There were 9
cases (5.63%, 9/160) with the twist movement(turning the steering wheel and cycling) had vascular flaps situated in
thoracic descending aorta, which significantly higher than the others (100.00%, 9/9 vs. 65.56%, 99/151; X2=4.592,
P=0.032).
Conclusions: These results showed the location of vascular flap is highly related with daily activity pattern in nontraumatic
acute aortic syndrome, which might be useful for clinicians when they prevent and cure this disease more timely
and effectively.
