BACKGROUND: @entity1410 (IMH) evolves very dynamically in the short-term to regression, dissection, or @entity1755 . The aim of the present study was to assess the long-term clinical and morphological evolution of medically treated IMH. METHODS AND RESULTS: Fifty of 68 consecutive @entity1 with aortic IMH monitored clinically and by imaging techniques at 3, 6, and 12 months and annually thereafter were prospectively studied. Mean follow-up was 45+/-31 months. In the first 6 months, total IMH regression was observed in 14 and progression to @entity1580 in 18 @entity1 ; in 14 of these, the dissection was localized, and 12 later developed @entity2849 . At the end of follow-up, the IMH had regressed completely without dilatation in 17 @entity1 (34%), progressed to classical dissection in 6 (12%), evolved to fusiform @entity439 in 11 (22%), evolved to saccular @entity439 in 4 (8%), and evolved to @entity2849 in 12 (24%). Evolution to dissection was related to echolucency (P<0.02) and to longitudinal extension of IMH (P<0.01). Multivariate analysis showed an independent association between regression and smaller maximum aortic diameter and between @entity439 formation and @entity731 and absence of echolucent areas in IMH. CONCLUSIONS: The most frequent long-term evolution of IMH is to aortic @entity439 or @entity2849 . Complete regression without changes in aorta size is observed in one third of cases, and progression to classical dissection is less common. A normal aortic diameter in the acute phase is the best predictor of IMH regression without complications, and absence of echolucent areas and @entity731 are associated with evolution to aortic @entity439 .

Long-term follow-up of aortic intramural XXXX : predictors of outcome.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1755 :: ('MESH:D001019', 'Disease') :: ['aortic rupture'] @entity1410 :: ('MESH:D006406', 'Disease') :: ['Aortic intramural hematoma'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysm'] @entity731 :: ('MESH:D050197', 'Disease') :: ['atherosclerotic ulcerated plaque'] @entity1580 :: ('MESH:C562834', 'Disease') :: ['aortic dissection'] @entity2849 :: ('MESH:D017541', 'Disease') :: ['pseudoaneurysm']
@entity1410 :: (MESH:D006406,Disease) :: ['hematoma']
