References
  1. Lazar HL, McDonnell M, Chipkin SR, Furnary AP, Engelman RM, Sadhu AR, et al. The Society of Thoracic Surgeons practice guideline series: Blood glucose management during adult cardiac surgery. Ann Thorac Surg. 2009;87: 663-9.
  2. Butterworth J, Wagenknecht LE, Legault C, Zaccaro DJ, Kon ND, Hammon JW Jr, et al. Attempted control of hyperglycemia during cardiopulmonary bypass fails to improve neurologic or neurobehavioral outcomes in patients without diabetes mellitus undergoing coronary artery bypass grafting. J Thorac Cardiovasc Surg 2005;130: 1319–23.
  3. Gandhi GY, Nuttall GA, Abel MD, Mullany CJ, Schaff HV, O’Brien PC, et al. Intensive intraoperative insulin therapy versus conventional glucose management during cardiac surgery: a randomized trial. Ann Intern Med 2007;146: 233–43.
  4. Nienaber CA. Diabetes mellitus and thoracic aortic disease: are people with diabetes mellitus protected from acute aortic dissection? J Am Heart Assoc. 2012;1:e001404.
  5. D’cruz RT, Wee IJY, Syn NL, Choong AMTL. The association between diabetes and thoracic aortic aneurysms. J Vasc Surg. 2019;69: 263-268.e1.
  6. Takagi H, Umemoto T; ALICE (All-Literature Investigation of Cardiovascular Evidence) Group. Negative Association of Diabetes with Thoracic Aortic Dissection and Aneurysm. Angiology. 2017;68: 216-224.
  7. Tsai CL, Lin CL, Wu YY, Shieh DC, Sung FC, Kao CH. Advanced complicated diabetes mellitus is associated with a reduced risk of thoracic and abdominal aortic aneurysm rupture: a population-based cohort study. Diabetes Metab Res Rev.2015;31: 190-7.
  8. De Rango P, Farchioni L, Fiorucci B, Lenti M. Diabetes and abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2014;47: 243-61.
  9. Hongtao Liu, Lei Shi, Tao Zeng, Qingwei Ji, Ying Shi, Ying Huang, et al. Type 2 diabetes mellitus reduces clinical complications and mortality in Stanford type B aortic dissection after thoracic endovascular aortic repair: A 3-year follow-up study. Life Sciences. 2019;230: 104–110.
  10. Riambau V, Böckler D, Brunkwall J, Cao P, Chiesa R, Coppi G, et al. Editor’s Choice e Management of Descending Thoracic Aorta Diseases Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2017;53: 4-52.
  11. Cosentino F, Grant PJ, Aboyans V, Bailey CJ, Ceriello A, Delgado V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2019;1-69.
  12. Hsu CY, Su YW, Chen YT, Tsai SH, Chang CC, Li SY9, et al. Association between use of oral-antidiabetic drugs and the risk of aortic aneurysm: a nested case-control analysis. Cardiovasc Diabetol. 2016;15: 125.
  13. Pafili K, Gouni-Berthold I, Papanas N, Mikhailidis DP. Abdominal aortic aneurysms and diabetes mellitus. J Diabetes Complicat. 2015;29: 1330-1336.
  14. Miyama N, Dua MM, Yeung JJ, Schultz GM, Asagami T, Sho E, et al. Hyperglycemia limits experimental aortic aneurysm progression. J Vasc Surg. 2010;52: 975-83.
  15. Harris KM, Braverman AC, Eagle KA, Woznicki EM, Pyeritz RE, Myrmel T, et al. Acute aortic intramural hematoma: an analysis from the International Registry of Acute Aortic Dissection. Circulation. 2012;126: S91-6.
  16. Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, et al. ESC Committee for Practice Guidelines. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J 2014; 35: 2873–2926.
  17. Bossone E, LaBounty TM, Eagle KA. Acute aortic syndromes: diagnosis and management, an update. European Heart Journal 2017;39: 739–49d.
  18. Song JK, Yim JH, Ahn JM, Kim DH, Kang JW, Lee TY, et al. Outcomes of patients with acute type A aortic intramural hematoma. Circulation 2009;120: 2046–2052.
  19. Pelzel JM, Braverman AC, Hirsch AT, Harris KM. International heterogeneity in diagnostic frequency and clinical outcomes of ascending aortic intramural hematoma. J Am Soc Echocardiogr 2007;20: 1260–1268.
  20. Ogino H. Uncomplicated type A intramural hematoma: surgery or conservative approach? -conservative approach. Ann Cardiothorac Surg. 2019;8: 558-560.
  21. Guzzardi DG, Barker AJ, van Ooij P, Malaisrie SC, Puthumana JJ, Belke DD, et al. Valve-Related Hemodynamics Mediate Human Bicuspid Aortopathy: Insights from Wall Shear Stress Mapping. J Am Coll Cardiol. 2015;66: 892-900.
  22. American Diabetes Association. 2. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019; 42: S13-S28.
  23. Glycemic Targets: Standards of Medical Care in Diabetes 2019. Diabetes Care 2019;42: S61–S70.
  24. Akin I, Kische S, Ince H, Nienaber CA. Indication, timing and results of endovascular treatment of type B dissection.Eur J Vasc Endovasc Surg. 2009;37:289-96.
  25. Eggebrecht H, Thompson M, Rousseau H, Czerny M, Lönn L, Mehta RH. Retrograde ascending aortic dissection during or after thoracic aortic stent graft placement: insight from the European registry on endovascular aortic repair complications. Circulation. 2009,120: S276-81.
  26. Evangelista A, Maldonado G, Moral S, Rodriguez-Palomares J. Uncomplicated type A intramural hematoma: surgery or conservative approach? -surgery. Ann Cardiothorac Surg. 2019;8: 556-557.
  27. Sandhu HK, Tanaka A, Charlton-Ouw KM, Afifi RO, Miller CC 3rd, Safi HJ, et al. Outcomes and management of type A intramural hematoma. Ann Cardiothorac Surg. 2016;5: 317-27.
  28. Tan Li, Jing-Jing Jing, Jun Yang, Li-Ping Sun, Yue-Hua Gong, Shi-Jie Xin, et al. Serum levels of matrix metalloproteinase 9 and toll-like receptor 4 in acute aortic dissection: a case-control study. BMC Cardiovascular Disorders. 2018;18: 219-26.
  29. Canaud L, Ozdemir BA, Patterson BO, Holt PJ, Loftus IM, Thompson MM. Retrograde aortic dissection after thoracic endovascular aortic repair. Ann Surg 2014;260: 389-95.
  30. Williams JB, Andersen ND, Bhattacharya SD, Scheer E, Piccini JP, McCann RL, et al. Retrograde ascending aortic dissection as an early complication of thoracic endovascular aortic repair. J Vasc Surg. 2012; 55:1255-62.
  31. Ma T, Dong ZH, Fu WG, Guo DQ, Xu X, Chen B, et al. Incidence and risk factors for retrograde type A dissection and stent graft-induced new entry after thoracic endovascular aortic repair. J Vasc Surg. 2018;67: 1026-1033.e2.
  32. Juvonen T, Ergin MA, Galla JD, Lansman SL, Nguyen KH, McCullough JN, et al. Prospective study of the natural history of thoracic aortic aneurysms. Ann Thorac Surg.1997;63: 1533-45.
  33. Elefteriades JA. Natural history of thoracic aortic aneurysms: indications for surgery, and surgical versus nonsurgical risks. Ann Thorac Surg 2002;74: 1877–80.
  34. Kitai T, Kaji S, Yamamuro A, Kinoshita M, Ehara N, Kobori A, et al. Detection of intimal defect by 64-row multidetector computed tomography in patients with acute aortic intramural hematoma. Circulation. 2011;124: S174-8.
Figure 1 CONSORT Diagram of Patient Selection
The CONSORT diagram of the patient selection process is shown in this figure. Thirteen individuals among the eligible uncomplicated type A intramural hematoma patients who refused further medical treatments or those without complete imaging records, laboratory test results and follow-up data were regarded as missing data. In our study, 5 of 114 patients who refused further medical treatment, lacked authentic laboratory/imaging data or were loss to follow-up were identified as missing data regarding eligible uncomplicated Type A IMH. The probability of these missing data did not depend on any factors that we considered, and such data were classified as missing completely at random; while the percentage of data missing was less than 10%, specifically, only 5.6% (5/114). For these reasons, we used the method of complete-case analysis in which we discarded these 13 cases with incomplete information. In total, 109 uncomplicated type A IMH patients with complete data were included in the study.