Work

Successful conservative treatment of type A aortic intramural hematoma with typical CT evolution: a case report

Year: 2025

Type: article

Abstract: Type A aortic intramural hematoma (IMH) is a variant of acute aortic syndrome, with emergency surgery traditionally considered the treatment of choice. We report a case of a 69-year-old male patient who presented with chest pain. Computed tomography angiography (CTA) revealed type A aortic intramural hematoma. Given the absence of high-risk progression factors, conservative management with close surveillance was selected. During treatment, periaortic hematoma developed in the descending aorta, but the patient's symptoms significantly improved. Follow-up CTA at 3 months demonstrated complete resolution of the intramural hematoma, and the patient remained in good condition at 2.5 years of follow-up. This case demonstrates that conservative treatment may be a viable option for highly selected type A IMH patients without high-risk progression factors, but should only be considered with rigorous patient selection criteria and intensive monitoring protocols in experienced centers.

Source: Frontiers in Cardiovascular Medicine

DOI: 10.3389/fcvm.2025.1648753

Authors: Jinlin Wu, Jiayu Song, Jie Liu

Institutions: Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Southern Medical University

Language: English

Topic: Aortic Disease and Treatment Approaches

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801