Patterns of visceral and renal artery involvement in type B aortic dissections

Objective: The main objective of this study was to describe the visceral and renal vessel involvement and the outcomes in thoracic dissections. Methods: Computed tomography scans of 39 patients were reviewed (30 type B, 9 type A). Visceral and renal arteries were recorded as perfused by the true lumen (TL) or false lumen (FL). Radiologic follow-up was 3.3 years (range 0-10). Results: A total of 156 vessels were analyzed, and 49 (31%) were supplied by the FL. The most common patterns were FL supply of a renal artery (RA) with the visceral arteries and contralateral RA from the TL. In the follow-up, branch vessel compromise occurred in 12 vessels and was more likely to occur when supplied by the FL (P = .01). About 75% of the patients with at least 2 vessels supplied by the FL demonstrated aortic dilatation. Conclusions: Branch vessel occlusion is more likely in the vessels supplied by the FL. Aortic dilatation occurred more frequently when 2 or more vessels were supplied by the FL.